Change in Process to Request a Bypass of Timely Filing Edits Applies to Connecticut, Delaware, and New York Part a Providers Only

In an effort to standardize our processes regarding claims submitted to Medicare untimely, we are making a change, effective immediately, in the way in which Part A providers in Connecticut, Delaware, and New York submit requests to bypass the timely filing system edits.

In the past, providers have been required to submit hardcopy claims with documentation to provide valid reasons for requesting the bypass of the timely filing system edit. Upon receipt of the information, the manager of the Claim’s Department would then make a decision as to whether or not the bypass could be completed.

We are now asking providers to submit these claims electronically and to indicate the reason for the request to bypass the untimely edit in the remarks field (UB-04, Field Locator 80). Upon receipt of the claims, we will suspend them internally for review so that a decision can be made as to whether or not we may bypass the untimely filing edit.

Claims will be rejected for being submitted to Medicare untimely if:

1. There are no remarks present;
2. The remarks are not sufficient enough; and
3. The reason for the request is not a permitted reason to bypass timely filing.

Thank you for your cooperation in this change in claims processing.

Posted: 04/15/2008