Author Topic: Highmark Medicare Billing  (Read 1429 times)


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    • Ability Billing Solutions LLC
Highmark Medicare Billing
« on: July 01, 2010, 01:07:20 PM »
Is there anyone out there who bill to Highmark Medicare( MD, DE, PA etc) and if so have you been experiencing problems with getting reimburstment or with claims being put on hold due to the rate change negotiation?


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Re: Highmark Medicare Billing
« Reply #1 on: July 01, 2010, 03:13:17 PM »
Hi Ty,

This bulletin is on Highmark Medicare's website about holding claims.

Print The 2010 Medicare Physician Fee Schedule

June 23, 2010

The Continuing Extension Act of 2010, enacted on April 15, 2010, extended the zero percent update to the 2010 Medicare Physician Fee Schedule (MPFS) through May 31, 2010.     

On May 27, 2010, the Centers for Medicare & Medicaid Services (CMS) initially instructed contractors to hold claims for services paid under the MPFS for the first 10 business days of June.  On June 14, CMS extended this hold for an additional three business days (i.e., through June 17, 2010).  This hold only affected MPFS claims with dates of service of June 1, 2010 and later.   

CMS today directed contractors to lift the hold and begin processing June 1 and later MPFS claims under the law's negative update requirement.  Held claims will be released and processed on a flow basis, first-in/first-out. 

Congress continues to debate the elimination of the negative update that took effect June 1, 2010.  The CMS is hopeful that Congressional action will be taken to avert the negative update and will continue to monitor those actions.  If Congress changes the negative update currently in effect, CMS is prepared to act expeditiously to make the appropriate changes to Medicare claims processing systems.

Source: LEARNRESOURCE-L Email Update, National Institutes of Health, U.S. Department of Health and Human Services dated June 18, 2010, Message 201006-20

This is the Link