Skip Navigation LinksHome | Editors' Blog

DecisionHealth stock imageYou can expect to see overpayment demands from CMS between now and November for Part B claims processed after April 1, 2011, the agency says. On April 1, CMS implemented a change request (CR 7026) that allowed its Common Working File to accept both Medicare as secondary payer (MSP) data and non-MSP data in claims adjustment lines. In English: Any patient who hasn't met the Medicare deductible, but has Medicare as the secondary payer, was issued coverage and had services paid as if the deductible were met, for claims processed anytime after April 1, 2011, CMS says.

DecisionHealth stock imageYou can look forward to overpayment demand letters -- based on audits by your recovery audit contractor (RAC) -- coming from your Medicare Administrative Contractor (MAC) or carrier, starting Jan. 1, 2012. Your MAC or carrier will now issue the demand letters, but everything else about the recoupment process will stay the same, including the 40-day discussion period and the appeals process.


User Name:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Blog Archive
Back to top