Jan. 6, 2014: Important Medicare date

Tuesday, December 17, 2013 03:15 PM

Today physicians and health care providers who bill Medicare are required to list the name and National Provider Identifier (NPI) of the ordering/referring physician or health care provider on their claims in order to be paid.

Starting Jan. 6, 2014, if the ordering/referring physician or health care provider listed on the claim is not enrolled in Medicare OR does not have a valid opt-out affidavit on file, then the billing physician’s claims will be denied. This requirement was originally scheduled to go into effect in 2010, but the American Medical Association and Medical Group Management Association (MGMA) successfully convinced the Centers for Medicare and Medicaid Services (CMS) to delay this several times so that more time could be given for physicians to enroll or opt-out.

Click here to read more in this bulletin from the AMA and MGMA.