The Medicare Monthly Review, MMR-2011-01, January 2011 - CGS

to the third party but no notification is provided on the RA. HIGLAS will communicate a TPP offset of aprovider’s payment on the provider’s RA.HIGLAS Impact on Claims ProcessingCurrently, our online system is available on federal holidays and National Government Servicesprocesses claims on some federal holidays. After transitioning to HIGLAS, our online system willcontinue to be available but claims will no longer be processed on federal holidays. There will be nochange to provider payments because National Government Services currently does not issue checks orEFTs on federal holidays.For further information, please visit our Web site by selecting “HIGLAS Transition for Part B –Connecticut and New York Providers” from the Jurisdiction 13 Part B home page atwww.NGSMedicare.com. If you have any questions regarding the information contained in this letter,please contact our Provider Contact Center toll-free at 866-837-0241.Centers for Medicare & Medicaid Services Articles for Part A and Part BProvidersCommon Working File Unsolicited Response Adjustments for CertainClaims Denied Due to an Open Medicare Secondary Payer GroupHealth Plan Record Where the GHP Record Was Subsequently Deletedor TerminatedMLN Matters® Number: MM6625 RevisedRelated Change Request (CR) #: 6625Related CR Release Date: December 3, 2010Effective Date: April 1, 2011Related CR Transmittal #: R2112CPImplementation Date: July 5, 2011Note: This article was revised on December 6, 2010, to reflect a revision to CR 6625. The implementationdate has been changed to July 5, 2011. The CR release date, transmittal number, and the Web address foraccessing CR 6625 has been revised. All other information is the same.Provider Types AffectedPhysicians, providers, and suppliers who bill Medicare contractors (fiscal intermediaries [FI], regionalhome health intermediaries [RHHI], carriers, Medicare administrative contractors [A/B MAC], or durablemedical equipment contractors [DME MAC] for services provided, or supplied, to Medicare beneficiaries.What You Need to KnowCR 6625, from which this article is taken, instructs Medicare contractors (FIs, RHHIs, carriers, A/B MACs,and DME MACs) and shared system maintainers (SSM) to implement (effective April 1, 2011) anautomated process to reopen Group Health Plan (GHP) Medicare Secondary Payer (MSP) claims whenrelated MSP data is deleted or terminated after claims were processed subject to the beneficiary record onMedicare’s database. Make sure that your billing staffs are aware of these new Medicare contractorinstructions. Please see the Background section, below, for more details.CPT codes and descriptors are only copyright 2010 American Medical Association (or such other date publication of CPT)The Medicare Monthly Review 23 MMR 2011-01, January 2011