Blog Single

15 Jul

USING YOUR FAX MACHINE MAY CAUSE MEDICARE CLAIM DENIALS


Warning: Invalid argument supplied for foreach() in /home/experics/public_html/wp-content/plugins/juiz-social-post-sharer/juiz-social-post-sharer.php on line 282

Medicare’s Part-B Medical Claim Processing Contractor for Florida has reported a potential problem using fax machine/systems to respond to their document requests and we are concerned that this problem may also occur in other regions and with other payors.

 

If you receive a request asking for additional claim documentation and you respond by fax before the filing deadline, you may still receive a denial for failing to respond within the required timeframe.

 

What May Happen

If the “Batch” setting on your fax machine/system is turned on, separate fax transmissions sent to the same destination number will be combined and appear at the receiving fax machine/system as a single fax. This occurs regardless of whether you processed them as individual faxes because your fax machine/system stores your outbound faxes until it completes sending to other destination numbers or until the destination fax machine/system answers. This “Batching” is not reported by your fax machine/system on its Confirmation Reports so you will not know that it occurred.

 

Why This Is A Problem

The automated imaging processing system used by Medicare’s Florida contractor only recognizes the first claim in a batch, logs and date stamps the documentation for that claim as received but does not recognize the other claims in the batch so nothing is logged as received for those claims.

 

What You Can Do

In order to ensure that your faxed document responses are not batched, investigate how your fax machine/system works by reading the User Manual then check that your fax machine/system is set up correctly. After making the appropriate setting changes to your fax machine/system you will want to send test faxes to another fax machine/system to confirm that yours is working as intended and not batching separate and unique documentation responses. We are happy to be the recipient of your test faxes and will let you know what we receive. Just call and tell us that you’re send a fax to test your system.

 

Another solution is to send your document responses by mail with tracking and delivery confirmation. Although you will incur postage costs, you will avoid claim denials due to the “fax batching” problem.

 

You can find more information about this issue online at: http://medicare.fcso.com/Medical_documentation/0342838.asp