CGS Holding All Part A SNF Claims
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H E A L T H C A R E U P D A T E |
November 11, 2011 |
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For additional information and discussion on this topic, please get in touch with your regular HW&Co. professional or one of our Revenue Cycle Consultants listed below. Pamela J. Skrzynski Kelly J. Sorensen, CMOM Jenna J. Bennett
Click here to see all of our previous e-newsletters. |
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BREAKING NEWS: CGS Holding All Part A SNF Claims |
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We have become aware that Ohio’s new Medicare Administrative Contractor (MAC), CIGNA Government Services (CGS), is currently not paying any Part A skilled nursing facility claims. The problem is related to new HIPPS codes created for Change of Therapy assessments, and per their interpretation of CMS instructions, CGS is holding ALL Part A claims for SNFs and Swing Beds. However, by all accounts, other MACs are interpreting the instructions differently and are paying all claims other than those affected by the new HIPPS codes. With the major cash flow issues that could occur if you do not receive your anticipated Medicare payment next week, we wanted to make you aware of the issue since you may not have checked the status of your October claims that you recently billed. This is especially important as the first quarter bed tax payment is due next week. Below is the Ohio Health Care Association’s latest update (used with permission): Medicare Part A Claims Remain Suspended: Directive to Pay Coming From CMS |
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