The Centers for Medicare & Medicaid Services (CMS) is alerting all providers, physicians and suppliers to a problem that occurred during the timeframe of May 26 through 28, 2009, and would have negatively impacted their patients’ crossover claims. On the indicated dates, Medicare contractors that utilize the Common Working File (CWF) Southeast host site for paid claims authorization for their beneficiaries who primarily reside or until recently resided in Alabama, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee, the United States Virgin Islands and Puerto Rico did not receive the customary confirmation from their host site that various claims were selected for crossover. The identified problem, which arose as part of the second CWF contractor transition, would have inhibited the crossing over of claims billed to Part A and Part B Medicare Administrative Contractors, carriers, fiscal intermediaries, and Durable Medical Equipment Medicare Administrative Contractors roughly during the timeframe of May 22 through 25, 2009, inclusive.
The CMS regrets the negative impact that the aforementioned Southeast CWF host site transition problem has caused and recommends that individual providers, physicians and suppliers take the following action: Examine your remittance advice or standard paper remittance advice to determine if your patients’ claims are identified as having been crossed over to your patients’ supplemental insurers. If you determine these claims were not crossed over, you are within your rights to submit claims to your patients’ insurers for supplemental payment using methodologies acceptable to those entities.
Questions concerning this broadcast may be directed to your local Medicare contractor’s Provider Relations Call Center.
JSMTDL-09-174-2, JSM/TDL- 09333