April 2024 Quarterly Release Temporary Hold

Published 03/06/2024

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

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 April 1, 2024, will be held in the status/location listed below and may be released before or on April 14, 2024, to continue processing. We anticipate claims will still be processed within a normal timeframe and these slight delays will not affect the timeliness of your payments.

Reason Code Location Status Description
36452 SMHOSP Hospice
37230 SMHOME Home Health PPS Claims
WW999 SMFISS Holds All Claims

This process does not apply to Home Health Notices of Admission (NOAs) and hospice Notices of Election (NOEs). These notices can still be submitted as normal to Palmetto GBA during this period. 

Providers should be reminded that Medicare claims processed by the 30th day from claim receipt are considered timely. Beginning on the 31 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.


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