Medicare Bad Debt Final Ruling

Medicare Bad Debt Final Ruling

On September 2, 2020, CMS released their Medicare Bad Debt final ruling, which contained several updates and clarifications to the regulations. Here are a few takeaways from the release:

  • The reasonable collection efforts performed by a provider or collection agency must be similar to the efforts put forth for non-Medicare patients of like balances.
  • The minimum 120-day collections effort period resets when a facility receives partial payments.
  • A provider must use its standard methods to determine if a beneficiary qualifies as an indigent non-dual eligible beneficiary and maintain documentation of such methods.
  • To determine if a State’s welfare agency is responsible for a dual eligible beneficiary’s deductible or coinsurance, an organization must bill the program and retain the remittance advice or comparable documentation for State’s without a remittance advice.

A facility must be in adherence with clarified regulations and the longstanding Medicare Bad Debt policies to receive reimbursement of sixty-five percent of the uncollectible amount. Unsure if your organization is in compliance? Reach out to Microscope for assistance. Our team will ensure your organization is effectively using this reimbursement vehicle.

For information, please contact:

Colin R. Conklin, CHFP

cconklin(at) / 315-559-6057

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