March 02, 2012

Start with CMS contractor when facing claim issues, expert advises

Keeping record

Providers who have claims being returned or have problems with claim entry systems need to start with their Centers for Medicare & Medicaid Services contractor, a CMS spokesman said Thursday.

“You have to let them know you are receiving these errors so that the contractors can submit these questions,” CMS's Jason Kerr said during the agency's Skilled Nursing Open-Door Forum.

Errors that one provider is receiving, especially involving large amounts of claims, could indicate a bigger problem.

“It could determine whether it's a national issue and we would want to get that resolved as quickly as possible,” Kerr said. “Contractors are also available for training. Use them to the best of your ability.”

You can download the Medicare Claim Review Program booklet here.

The next SNF Open-Door Forum will be Thursday, April 12. Attendees will be able to attend in person or in conference call format. A recent experiment using web streaming proved problematic, organizers explained.