CMS Sets July Deadline for Electronic Claims Compliance

BALTIMORE–A few exceptions aside, CMS will no longer process
paper claims starting July 5.

According to a Change Request transmittal posted in January, all
paper claims Medicare carriers receive will appear on a report.
“Providers will have to submit an explanation of why they are
submitting this way,” a CMS spokesperson said. “If they cannot
justify a reason, their claims will be denied.”

Even though CMS is enforcing the electronic claims requirement,
the agency has not yet set a final deadline for enforcing
HIPAA-compliant code sets. Since CMS’ original deadline for filing
HIPAA-compliant claims a year-and-a-half ago, about 17 percent of
all providers who file are still non-compliant, the spokesperson
said. He added, though, that non-compliant providers submit only a
small fraction–less than 1 percent–of all the claims Medicare
processes. “We’re just trying to get everyone else onboard,” he
said.

Part of HIPAA’s Administrative Simplification Compliance Act,
small providers and those who meet other exception criteria can
continue to submit paper claims. To view these exceptions, and for
more HIPAA information, visit CMS’ Web site by clicking here. To
view the Change Request posted on the CMS Web site, click
here. For more news, visit this week’s HomeCare Monday,
available at www.homecaremonday.com.