Provider Notifications/Updates

IMPORTANT INFORMATION

MEDICARE CLAIMS TIMELY FILING

As a result of the Patient Protection and Affordable Care Act (PPACA), the Center for Medicare and Medicaid Services (CMS) has changed the timely filing requirements.

Effective immediately, all claims for dates of service on or after January 1, 2010 must be filed with Care1st Health Plan within one calendar year from date of service. Care1st Health Plan will deny claims billed after one calendar year from date of service.

For claims submitted with date span on CMS-1500, the "From" date is used for determining claim filing timeliness. For Institutional claims, the "Through" date is used for determining claim filing timeliness.

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