Medical review clock restarts with ZPIC notice; MREP Windows 7 bug addressed

by: Roy Edroso Jan 31, 2013

Medical review clock restarts with ZPIC notice. A CMS transmittal on “Medical Review Timeliness Requirement” effective Feb. 19, 2013, will mean longer waits for decisions on claims sent to integrity contractors. Previously, when a MAC or RAC referred your claims information to PSCs and ZPICs for BI (Benefit Integrity) investigation, it was obliged to return a decision to you 60 days after sending their request to the integrity contractors. Now “the 60-day time period will be restarted on the date the MAC receives requested input from the ZPIC or is notified by the ZPIC that the referral has been declined.” See the transmittal at http://tinyurl.com/af8lsg9.

MREP Windows 7 bug addressed. CMS has distributed an MLN Matters Article announcing an enhancement is being performed by Viable Information Processing Systems (ViPS) on the Medicare Remit Easy Print (MREP), the program used to view and print HIPAA-compliant Electronic Remittance Advice (ERA). The enhancement is meant to address a technical issue reported by users with Windows 7, XP and Vista. Once the enhancement is finished, CMS says you will be notified by your carrier, B MAC or DME MAC effective July 1, 2013. See the MLN Matters Article at http://tinyurl.com/b6gs3kn.

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