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MACs supply tips on securing advance payments as early approvals swell to $34B

Update: On March 9, CMS announced that its regional contractors had released more than $51 billion to health care providers around the nation since the agency expanded its advanced payment program. The agency has approved more than 21,000 requests. That's up from the $34 billion in payments and 17,000 approvals CMS announced previously.
Since CMS expanded the Accelerated and Advanced Payment (APP) program in late March, the agency has approved the release of nearly $34 billion to health care providers seeking a financial salve during the COVID-19 public health emergency (PHE).
Now you'll find clearer guidance from Medicare administrative contractors (MAC) that are coordinating the regional relief efforts. Each MAC is offering designated forms to providers seeking up-front payments, which Part B providers can request for up to 120 days.
The expedited APP process that CMS put into place on March 28 has shortened the response times of MACs from three to four weeks to as little as four days. The federal agency reports that it received some 25,000 requests during the first week of the new APP program, and approved 17,000 of those requests.
As interest in the APP program grows, some MACs have started to issue guidance to providers on how they can get their financial request forms cleared with as little obstruction as possible.
National Government Services, the MAC covering more than 400,000 Part B providers in New York and nine other states, put out a frequently asked questions (FAQ) document, providing tips on which providers' names and data belong on the request forms, what to do in a group practice with multiple providers and who needs to sign off on the form.
Note that MACs are processing the request forms in the order in which they are received, so your timeliness in submitting a document with the required details is paramount in receiving advance payments as soon as possible.
"Due to overwhelming provider response to the accelerated/advanced payment requests, we are processing requests as expediently as possible," NGS states in the FAQ. "When payments are processed, you will receive a response to your email regarding the payment amount. We are reaching out directly to any providers that have incomplete submissions and/or if we have any questions needed to process the payment request."
Request for additional information could delay a much-needed financial infusion as practices grapple with low patient volume, staffing cuts and other repercussions of the COVID-19 crisis.
Palmetto GBA, the MAC covering Tennessee, Virginia and five other states, also posted a series of FAQs for providers. One question, for example, pertains to the billing provider information that's required on the APP form:
  • "Question: Do I complete the form for every provider in our practice?"
  • "Answer: Forms only need to be completed for each billing PTAN/NPI combination. Rendering physician PTAN/NPI requests are not needed. Note: To submit one request for multiple PTAN/NPI combinations in your practice, you may submit a spreadsheet."
NGS Medicare provided details on signature requirements:
  • "Who can sign the accelerated/advance payment requests?"
  • "The form must be signed by the provider’s authorized official that is legally able to make financial commitments and assume financial obligations on behalf of the provider. It must be the person identified in PECOS as the authorized/delegated official."
Other questions dive into the details of the repayment plan and providers' financial responsibility. For example, Palmetto GBA explains that CMS will base advance payments on a provider's Medicare billing history. The "accelerated payment amount is based on the provider’s Medicare reimbursement history and is not calculated based on other payer revenues," the MAC states.
Unsure of your MAC? Find them here.
Once you navigate to the home page of your MAC, you should see a "COVID-19 crisis" link, which will direct you to the appropriate APP program details, including the request form and submission instructions.
Blog Tags: CMS, COVID-19, MACs
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