The Centers for Medicare & Medicaid Services (CMS) reminds all providers, physicians, and suppliers to allow sufficient time for the Medicare crossover process to work-approximately 15 work days after Medicare's reimbursement is made, as stated in MLN Matters Article SE0909 (http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0909.pdf) - before attempting to balance bill their patients' supplemental insurers. That is, do not balance bill until you have received written confirmation from Medicare that your patients' claims will not be crossed over, or you have received a special notification letter explaining why specified claims cannot be crossed over. Remittance Advice Remark Codes MA18 or N89 on your Medicare Remittance Advice (MRA) represent Medicare's intention to cross your patients' claims over. Medicare will continue to issue supplemental notifications to all participating providers, physicians, and suppliers informing them if claims targeted for crossover, as evidenced by MA18 or N89 on the MRA, do not actually result in successful crossover transmissions.
Members of the supplemental payer/Medigap market are noting higher than average receipts of Medicare Part A paper claims that are preceding the arrival of Medicare's 837 institutional COB crossover claims. The arrival of paper claims in advance of Medicare crossover claims is resulting in supplemental payer receipt of duplicate claims. This trend is particularly pronounced among hospital providers within the states of Iowa, Missouri, and Wisconsin. Current trending suggests that approximately 99 percent of all claims that Medicare identifies for crossover, as cited on your Medicare Remittance Advice, actually are crossed over by CMS' Coordination of Benefits Contractor (COBC). The remaining percentage error out at the COBC due to HIPAA compliance issues or related data errors, resulting in the provider, physician, or supplier's receipt of a Medicare-generated special notification letter specifying the reason for the claim's failure to cross over. This trending demonstrates that the crossover process is becoming more reliable all the time. The CMS requests that providers, physicians, and suppliers ensure that the trend continue. ________________________________________________________________________ _____________ Flu Season is Here! Annual outbreaks of the seasonal flu usually occur from late fall to early spring. Typically, 5 to 20 percent of Americans get the seasonal flu, resulting in approximately 36,000 flu-related deaths.[1] If you have Medicare patients who haven't yet received their flu shot, you can help them reduce their risk of contracting the seasonal flu by recommending an annual seasonal influenza vaccination. Medicare provides coverage of the seasonal flu vaccine and its administration. And don't forget to immunize yourself and your staff. Protect yourself, your staff, your patients, and your family and friends. Remember - Influenza vaccine plus its administration are covered Part B benefits. Note that influenza vaccine is NOT a Part D covered drug. For information about Medicare's coverage of the seasonal influenza virus vaccine and its administration as well as related educational resources for health care professionals and their staff, please go to http://www.cms.hhs.gov/MLNProducts/Downloads/flu_products.pdf on the CMS website. You will find a variety of resources that explain Medicare coverage and claims submission policies related to the seasonal influenza vaccine. For information on Medicare policies related to H1N1 influenza, please go to http://www.cms.hhs.gov/H1N1 on the CMS website. -------------------------------------- [1] Flu.gov. 2009. About the Flu [online]. Washington DC: The U.S. Department of Health and Human Services, 2009 [cited 30 November 2009]. Available from the World Wide Web: (http://www.flu.gov/individualfamily/about/index.htm <http://www.flu.gov/individualfamily/about/index.html> ) ------------------------------------------------------------------------ ------------------------------------------------------------------------ -------------------------------------- Note: If you have problems accessing any hyperlink in this message, please copy and paste the URL into your Internet browser. If you received this message as part of the All FFS Providers listserv, you are currently subscribed to one of eighteen Medicare Fee-For-Service provider listservs. If you would like to be removed from all NIH listservs, please go to (https://list.nih.gov/LISTSERV_WEB/signoff.htm <https://list.nih.gov/LISTSERV_WEB/signoff.htm> ) to unsubscribe. If you would like to unsubscribe from a specific provider listserv, please go to (https://list.nih.gov/cgi-bin/show_list_archives <https://list.nih.gov/cgi-bin/show_list_archives> ) to unsubscribe or to leave the appropriate listserv. Please DO NOT respond to this email. This email is a service of CMS and routed through an electronic mail server to communicate Medicare policy and operational changes and/or updates. Responses to this email are not routed to CMS personnel. Inquiries may be sent by going to (http://www.cms.hhs.gov/ContactCMS <http://www.cms.hhs.gov/ContactCMS> ). Thank you. ________________________________ ________________________________ [1] Flu.gov. 2009. About the Flu [online]. Washington DC: The U.S. Department of Health and Human Services, 2009 [cited 30 November 2009]. Available from the World Wide Web: (http://www.flu.gov/individualfamily/about/index.htm <http://www.flu.gov/individualfamily/about/index.html> )
