Important Information on the Timely Claims Filing Requirement

The Centers for Medicare & Medicaid Services (CMS) would like to remind 
Medicare Fee-For-Service physicians, providers and suppliers submitting claims 
to Medicare for payment, as a result of the Patient Protection and Affordable 
Care Act (PPACA), effective immediately, all claims for services furnished on 
or after Jan 1, 2010, must be filed with your Medicare contractor no later than 
one calendar year (12 months) from the date of service - or Medicare will deny 
them.


If you have Medicare Fee-For-Service claims with service dates from Oct 1, 
2009, through Dec 31, 2009, those claims MUST be filed by Dec 31, 2010, or 
Medicare will deny them. Claims with service dates from Jan 1, 2009, to Oct 1, 
2009, keep their original Dec 31, 2010 deadline for filing.



In general, the start date for determining the 1-year timely filing period is 
the date of service or "From" date on the claim.  For institutional claims that 
include span dates of service (i.e., a "From" and "Through" date on the claim), 
the "Through" date on the claim is used for determining the date of service for 
claims filing timeliness.  For claims submitted by physicians and other 
suppliers that include span dates of service, the line item "From" date is used 
for determining the date of service for claims filing timeliness.



For additional information about the new maximum period for claims submission 
filing dates, contact your Medicare contractor, or review the MLN Matters 
articles listed below related to this subject:



§  MM6960 - "Systems Changes Necessary to Implement the Patient Protection and 
Affordable Care Act (PPACA) Section 6404 - Maximum Period for Submission of 
Medicare Claims Reduced to Not More Than 12 Months" - 
http://www.cms.gov/MLNMattersArticles/downloads/MM6960.pdf on the CMS website.

§  MM7080 - "Timely Claims Filing: Additional Instructions" - 
http://www.cms.gov/MLNMattersArticles/downloads/MM7080.pdf on the CMS website.



You can also listen to a podcast on this subject by visiting 
http://www.cms.gov/CMSFeeds/02_listofpodcasts.asp on the CMS website.


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December Flu Shot Reminder

It's a Busy Time of Year.  Make each office visit an opportunity to talk with 
your patients about the importance of getting the seasonal flu vaccination and 
a one-time pneumococcal vaccination.  Remember, Medicare pays for these 
vaccinations for all beneficiaries with no co-pay or deductible. The seasonal 
flu and invasive pneumococcal disease kill thousands of people in the United 
States each year, most of them 65 years of age or older. The Centers for 
Disease Control and Prevention (CDC) also recommends that health care workers 
and caregivers be vaccinated against the seasonal flu. Protect your patients. 
Protect your family. Protect yourself. Get Your Flu Vaccine - Not the Flu.



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 influenza vaccine and its 
administration, as well as related educational resources for health care 
professionals and their staff, please visit the following CMS websites: 
http://www.cms.gov/MLNProducts/Downloads/Flu_Products.pdf and 
http://www.cms.gov/AdultImmunizations.



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