Accelerated payment – Part A only

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Home ► PARD provider reimbursement ► Accelerated payment – Part A only

Last Modified: 8/14/2024 Location: FL, PR, USVI Business: Part A

Accelerated payment – Part A only

An accelerated payment may be issued in the following circumstances:

• A delay in payment for covered services rendered to beneficiaries and this delay has caused financial difficulties for the provider,

• Provider has incurred a temporary delay in its bill processing beyond the provider’s normal billing cycle, or

• CMS deems an accelerated payment is appropriate.

Provider eligibility for accelerated payments is contingent on the provider meeting all of the following conditions:

• A shortage of cash exists whereby the provider cannot meet current financial obligations; and

• The impaired cash flow is due to abnormal delays in claims processing and/or payment by the MAC (Medicare Administrative Contractor). Requests for accelerated payments based on isolated temporary provider billing delays may also be approved where the delay is beyond the provider’s normal billing cycle. In this instance, the provider must assure and demonstrate that its billing delays are being corrected and are not chronic; and

• The provider’s impaired cash flow would not be alleviated by receipts anticipated within 30 days which would enable the provider to meet current financial obligations; and

• The basis for financial difficulty is due to a lag in Medicare billing and/or payments and not to other third-party payers or private patients; and

• The MAC is assured that recovery of the payment can be accomplished within 90 days.

If the provider is determined to be eligible, the amount of the accelerated payment is computed as a percentage sufficient to alleviate the impaired cash flow not to exceed 70% of the amount of net reimbursement represented by unbilled discharges or unpaid bills applicable to covered services.

A letter is sent to the CMS Regional Office to request final approval of the accelerated payment.

Upon receiving CMS’ response of concurrence or disapproval, the provider is immediately notified.

Complete the appropriate accelerated payment form pdf file

and email it along with your request to:

• gregory.mahoney@fcso.com

• dawn.hooper@fcso.com

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