Medicare Claims Expiring 12/31/10

The Patient Protection and Affordable Care Act (PPACA) amended the timely filing requirements to reduce the maximum time period for submission of Medicare claims to one calendar year after the date of service. Medicare billing claims for the period of October 1, 2008 through December 31, 2009, will expire on December 31, 2010. Since the 31st is a holiday, all claims must meet the Medicare clean claim definition by December 30 at 3pm, in order to be processed. The Medicare definition of a clean claim is one that has no defect, impropriety, lack of any substantiating data, or particular circumstances requiring special treatment that prevents a timely payment (42 CFR 422.500). If a claim does not meet this definition, it will be returned to the provider with no right to appeal.  Contact your HW Healthcare Advisor if you need assistance filing your claims.