Monday, March 9, 2015

CMS Update-Automation of the Request for Reopening Claims Process

Dan Ciolek


The Centers for Medicare and Medicaid Services (CMS) recently updated MLN Matters®Number: MM8581 titled ‘Automation of the Request for Reopening Claims Process’. This article is based on CR 8581 which informs A/MACs about changes that will allow providers and their vendors to electronically request re-openings of claims.

In this document, clarifications were made regarding the relationship of re-openings to timely filing and also to certain denied claims lines and to clarify the need for a "Remarks" field code for certain re-openings. In addition, the effective and implementation dates are revised. All other information remains the same. Make sure your billing staffs are aware of these changes.

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