Do extra housekeeping as post-shutdown payments clear

by Roy Edroso on Dec 3, 2025
Afzal says you “may see brief timing variability with the MACs as queues clear, but this is essentially a return to standard cash flow. Medicare fee-for-service payments come from the Medicare Trust Funds (HI/SMI) – not annual discretionary appropriations –so Medicare claim operations generally continued even when other parts of the government slowed down.”
 
As claims return to normal, pay attention to these details:
  • Closely watch MAC bulletins and remittance advice as the backlog clears for any processing quirks.
  • Make sure the claims you submit are clean: modifiers are accurate, NPIs and TINs match, and medical necessity is well-documented.
  • Monitor days in accounts receivable for the next few cycles; small timing swings are standard as contractors normalize.
  • If you held claims, stage releases over 24-48 hours to prevent avoidable rejections due to volume spikes.
  • Coordinate with revenue cycle management teams and clearinghouses so that auto-postings and reconciliations track to catch-up electronic funds transfers (EFT).
  • Follow cash-flow discipline and avoid large disbursements until your first two Medicare EFTs land as expected.
Note also, Afzal says, that in the wake of the shutdown “telehealth will need closer eligibility and coding checks given the post-waiver landscape,” and act accordingly (PBN 11/24/25).
 

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