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Latest News on Medicare Claims Delays

CMS recently announced that it asked all Medicare Administrative Contractors to hold RHC Medicare claims submitted on or after April 1, 2016 due to processing problems. It was not immediately clear how significant the problem was or how long it would take to fix.

According to CMS staff, the problem is serious and will take about 10 days to resolve, but it is not quite as major as first feared. The programmers think they will have a fix in place between April 21 and April 25.

Since Medicare must already hold all claims for 14 days prior to processing, it appears that RHC Medicare claims with a date of service between April 1 and April 9/10 will not be paid until the fix is completed. This assumes that the programmers are able to fix the problem within their current timeframe. If it takes longer, claims with a later date of service will be impacted as well.

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