CMS RELEASES INFORMATION ON HOLDING 2012 CLAIMS
By: Bellinger P. Moody, RHIA, CPC, CCP, CPC-I
Executive Vice President of Compliance

12/21/2011

This past Monday (December 19th) the Centers for Medicare & Medicaid Services (CMS) instructed all of the Medicare Carriers (Contractors) to hold all 2012 claims for the first 10 business days of January (i.e., January 2, 2012, through January 13, 2012). This claims hold will impact provider cash flow – but it should be minimal – because, under current law, clean electronic claims are not paid sooner than 14 calendar days (29 days for paper claims) after the date of receipt.

Those Medicare claims for services rendered on or before December 31, 2011, will not be affected by the 2012 claims hold and will be processed and paid under normal procedures and time frames.

According to CMS, they will notify you on or before January 11, 2012, with more information about the status of Congressional action to avert the Medicare pay cut, as well as next steps regarding the claims hold.

The information presented herein reflects general information that is current as of the date it was first published.  In light of changes that may occur in the health care regulatory and compliance environments, the author's presentation of this information might become outdated.  Please check with your individual legal and/or compliance advisor(s) prior to taking any significant actions based upon the information and advice presented.