tci Part B Insider - 2009 Issue 37

Compliance: Wrong Address on File? MACs Can Repeal Your Billing Rights

Make sure your carrier's system has accurate information for your practice. Effective Nov. 2, your practice might be getting a house call from Medicare, and the purpose is simply to make sure you're there. According to CMS Transmittal 306, "all providers and suppliers are subject to unannounced site visits prior to receiving Medicare billing privileges or subsequent to receiving Medicare billing privileges." In certain cases, CMS will instruct a MAC to make a visit to a medical practice to determine if the practice is operational at the address on file. If the MAC representative can't tell from an...

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