Last Modified: 10/7/2011
Location: FL, PR, USVI
Business: Part A
Filing/Billing instructions inquiry
Where can I find instructions to submit/correct a claim and the timeliness filing guidelines?
You can find information regarding the requirements to file a claim on the Centers for Medicare & Medicaid Services (CMS) website, within the Internet -only manuals (IOMs). An example is: Publication 100-04, Chapter 25 -- Completing and Processing the Form CMS-1450 Data Set
, which walks you through the entire UB-04 (uniform billing) claim form describing the type of bills, how to correct a claim (or adjust a claim), etc.
CMS also has a Web-based training (WBT) module titled, "Uniform Billing (UB)-04 (July 2008)." You can locate the WBT by clicking on this link http://www.cms.gov/MLNProducts/
, scrolling down to "Related links inside CMS," and clicking on "Web-based training modules."
You can locate information on the timely filing limits from this link: Publication 100-04, Chapter 1
, Section 70 -- Time Limitations for Filing Part A and Part B Claims.
Where can I find information on filing a claim for Durable Medical Equipment Prosthetic, Orthotics & Supplies (DMEPOS)?
You can find information regarding the requirements to file a DMEPOS claim within the CMS IOM, Publication 100-04, Chapter 20
or you can contact CIGNA
, the DME Medicare Administrative Contractor (MAC) for jurisdiction C.
Source: FCSO Education Action Team