Palmetto GBA has received the revised fee schedule from CMS with the 2.2% increase for services from June 1 through November 30, 2010. They are testing their system with the new fee schedule, and should have everything pricing correctly by this Thursday, July 1.
Palmetto has provided CMA with the following additional information on the previously held June claims:
· Claims with June dates of service received on June 1 and June 2 were released and paid at the lower fee schedule (about 15,000 claims) before Palmetto was again instructed to hold claims.
· The rest of the held claims will be released a day or two at a time, with the oldest claims being processed first . This will be a rolling release, with the volume depending on how many current claims are received.
· The claims for dates of service June 1 and after that were paid at the lower fee schedule will be automatically adjusted up to the new fee schedule amount (or submitted charge, whichever is lower), but not for a couple of weeks. Adjustments can only take place after the claims are finalized.
· Some physicians continued to submit claims at the fee schedule amounts that were in effect from January through May. Palmetto GBA cannot automatically adjust these claims. Physicians will have to submit corrections to the written reopening post office box (see address below). Physicians may request an adjustment to the billed charge by submitting a spread sheet indicating the procedure code, the corrected submitted charge, the ICN (claim number) of the claim and the paid date. They can also submit the EOB’s and include a list of the procedure codes with the corrected billed charge. Physicians should use the reopening form from Palmetto’s website. Requests for reopening should be sent to: Palmetto GBA, Part B J1 MAC, P.O. Box 1252 Augusta, GA 30903-1252
Palmetto GBA is hoping to post the new fee schedule on their website by the end of the week.
Contact: CMA’s member service center, 800/786-4CMA or memberservice@cmanet.org.
Last Updated Wednesday, June 30, 2010 - 07:01 PM.
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