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On August 15, 2003, the Department of Health and Human Services (HHS)published the Interim Final Rule for Electronic Submission of Medicare Claims. This interim final rule implements the statutory requirement found in the Administrative Simplification Compliance Act (ASCA). ASCA requires all claims sent to the Medicare Program be submitted electronically starting October 16, 2003. The rule is available at:
The regulation requires that all claims submitted to Medicare on
October 16, 2003 and beyond be done so electronically except for certain circumstances including:
The provider is a small provider
Dental claims
Claims where there is more than one payer primary to Medicare
Roster billing for vaccinations
Claims for Medicare demonstration projects
While these claims may be submitted electronically, they are not
required to be done that way.
October 16, 2003 and beyond be done so electronically except for certain circumstances including:
The provider is a small provider
Dental claims
Claims where there is more than one payer primary to Medicare
Roster billing for vaccinations
Claims for Medicare demonstration projects
While these claims may be submitted electronically, they are not
required to be done that way.
For additional information, visit the CMS HIPAA Information Site at: http://www.cms.hhs.gov/hipaa/hipaa2/
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