PPACA offers new timely claims submission rule

by CHARLES FIEGL on Apr 5, 2010

Photo courtesy of NIH Image BankProviders no longer have 15 to 26 months to file Medicare claims. The Patient Protection and Affordable Care Act (PPACA) now requires practices to submit claims within 12 months of the date of service.

So, a claim for any service provided to a Medicare patient in 2010 will need to be submitted one calendar year later. But there are a few wrinkles to keep in mind:

  • Claims for services between Oct. 1, 2009, and Dec. 31, 2009, need to be submitted by Dec. 31, 2010.
  • Claims for services rendered before Oct. 1, 2009, will follow the previous rules for timely Medicare claims.

The change is considered a fraud, waste and abuse provision -- not just a change to make a provider's life more difficult. Also, the new timely claims rules aren't set in stone. HHS has the power to alter the timely claims provision in future rule making.

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