As you know, the Centers for Medicare & Medicaid Services (CMS) delayed Medicare claim processing to give Congress more time to come to an agreement on legislation to stop the 10.6 percent physician payment cut. However, because federal law does not allow payments to be held for more than 10 days, carriers were required to begin processing those held claims on July 15 and some physicians will receive payments at the lower rates. CMS has instructed carriers to automatically reprocess these claims as soon as their systems have been updated with the pre-July 1 rates.
NHIC, California’s Medicare carrier, has indicated that it will implement the new fee schedule in 10 business days or less. Claims with dates of service of July 1 and later that were billed at the pre-July 1 rates will be automatically reprocessed. Physicians who submitted claims at the lower rates will need to contact NHIC to request an adjustment.
