tci Medicare Compliance & Reimbursement - 2008 Issue 34

Reader Question:CMS Proposed Changing Payment Guidelines for Non-Credentialed Physicians

Under proposed plan, CMS would no longer allow retroactive billing for newly-credentialed doctors. Question: In your last issue, your reader question discussed how practices can hold a physician's claims while waiting for Medicare to credential the doctor, and then the practice can later send in all of that doctor's claims for retroactive payment after Medicare has credentialed him. However, I heard that Medicare is planning to end the retroactive billing rule and allow us to only bill for services the physician provides after Medicare credentials him. Is this accurate? Answer: Medicare did propose such a plan with an announcement...

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