What this means to you is that you will no longer see any biller purged reports from us, and more rejected claims will appear on your remittance advice. We are currently developing a process for claims that cannot be rejected through the remittance process and will notify you as soon as it is completed. In order for us to be able to return these claims via the remittance process, we will have to change the invalid information that was submitted to a “dummy code.” You will still be able to identify the claim using the information on your receipt listing report. This change will be effective with the transition to MCS that is scheduled for May 2, 2005.
Below is a list of reasons a claim could be rejected and how to recognize it on your remittance report:

1. Can’t identify the patient by name or Medicare number, invalid Medicare number - the claims will be processed with dummy Medicare number - 999-99-9999A - ANSI code MA27
    
2. Invalid/incomplete date of service - the claim will be processed with dummy date 01/01/99 - ANSI code M59

This is not an all-inclusive list, and other situations may be added to our list as they become known.

Remember: Proper claims submission is important for correct reimbursement. Failure to follow CMS guidelines could cause a delay in processing, denial of the claim, or affect processing.