July 2021 Quarterly Release Temporary Hold

Published 06/23/2021

Each quarter, the Fiscal Intermediary Shared System (FISS) is updated to include new logic for claims processing, pricing, and so on.

When the release is installed, Palmetto GBA places a temporary hold to ensure the release is installed properly. During this time, claims with dates of service on or after July 1, 2021, will be held in the status/location listed below and may be released before or on July 14, 2021, to continue processing. 

Reason Code

Location Status

Description

WW999

SMFISS

Holds All Claims

Providers should be reminded that Medicare claims processed by the 30th day from claim receipt are considered timely. Beginning on the 31st day from receipt, interest will be applied to clean claims that have not been processed. A “clean claim" is one that does not require the Medicare Administrative Contractor to investigate or develop external to their Medicare operation on a prepayment basis.