May 2004 Newsletter

Claims' Supporting Doc

By:Janet Browning, Quality Assurance

Medicare Claims - Electronic Requirement

As mentioned in a previous edition of our newsletter, Medicare requires that providers submit their initial Medicare claims electronically. In order to facilitate this process, Palmetto GBA, the Medicare intermediary for Ohio and West Virginia offers the availability of a fax service to submit additional documentation. The documentation may be faxed on the same day the electronic claim is submitted, or one to two days prior. The fax cover sheet must accompany each document. When submitting the claim, the word "FAX" must be indicated in the documentation of the electronic claim. For HARP clients, FAX should be entered in the Prior Authorization field of the ticket.

The EDI fax cover sheet can be downloaded from their web site. To access the form, go to: Providers > Part B > Ohio or West Virginia > EDI.

Other articles this quarter by Janet Browning: ICD Grace Period Gone, HCPCS Grace Period Gone.