General Category > General Questions
Medicare Re-enrollment and Billing Older Claims
Michele:
When they reactivate it is as if there was never an interruption in the provider's enrollment so yes, you can go back and rebill all claims under 365 days.
PMRNC:
That's not what it says..
Nevertheless, the effect of the process that CMS has
instructed MACSs to follow denies the suppliers the right to bill
for services even though their Medicare Participation
Agreement remained in effect. Claims for services from the date of deactivation to the date of reactivation may not be payable.
42 CFR 424.540 (as adopted 71
Fed. Reg. 20776 (4/21/2006).
Michele:
I am basing my comments on our experiences. We have had to reactivate several providers and they were allowed to bill all dates in between. Not surprised that Medicare has one thing in writing but says another. I haven't done one in a year or two so maybe they are not allowing that anymore.
PMRNC:
It's possible they are allowing the MAC their own discretion? I've never had a deactivation at all. Maybe that's why it says "May not be covered".
Michele:
Maybe, not sure. :)
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