tci Medicare Compliance & Reimbursement - 2022 Issue Q4

Reader Question: Know This Medicare Claims Filing Due Date

Question: We had a problem with a claim and didn’t get it filed with Medicare until over a year after the procedure date. Will this get paid? Louisiana Subscriber Answer: No. The Centers for Medicare & Medicaid Services (CMS) gives you only 12 months to file a claim, and exceeding this limit will cause instant denials. The time period for filing Medicare fee-for-service claims was amended as part of the Patient Protection and Affordable Care Act (PPACA). Under this law, the claims for services furnished on or after Jan. 1, 2010, must be filed within one calendar year...

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