Three details:
1. Beginning in July, CMS will reject a Medicare outpatient claim if:
- The service location address doesn’t exactly match the address listed on the 855A enrollment form in the Provider-Enrollment, Chain and Ownership System
- A hospital with multiple locations doesn’t report the correct location where the service was rendered
2. The guidance means spelling differences or abbreviations — such as “Rd.” instead of “Road” — can cause an outpatient claim to be rejected.
3. CMS created a query function allowing hospitals to cross-check their claim addresses with the ones listed in PECOS. JD Supra advised hospitals to immediately begin reviewing the records “so as to avoid potential roadblocks.”
More articles on coding, billing and collections:
Third-party vendor hack exposes nearly 12M Quest Diagnostics records — 5 takeaways
3 things to know about out-of-network payments’ effect on ASC value
The changing bundled payment landscape for ASCs — What to know about risk, payers & future trends
