This is an article from the WPS Medicare Listserv

E-News letter on 7/22/2008

III.�������� NATIONAL PROVIDER IDENTIFIER (NPI) CLAIM UPDATE

Suspended claims with NPI issues are being submitted multiple times by providers.

WPS Medicare is finding that claims suspended within their system for NPI issues are being submitted multiple times. Before re-filing a claim, allow sufficient time for the claim to reach Medicare, for Medicare to process the claim and for the Provider Remittance Notice (PRN) to reach you. If you do not submit claims electronically or receive your remittance notice electronically, you must allow time for mail processing and delivery.

WPS Medicare recommends that you wait 60 days before re-filing any claim. This allows 45 days past the payment floor for any development that may occur on a claim.

Claim processing time cannot be shorter than the "payment floor" which is 14 days for electronic claims and 29 days for paper claims. This is the minimum amount of time that must elapse from the date Medicare receives the claim until the date Medicare issues a payment. Actual processing time can take longer on some claims. Also, before re-filling, always carefully review your PRN to reconcile your records, or access the Interactive Voice Response (IVR) system or C-SNAP for claim status.

Do not automatically re-file claims to Medicare Part B without first obtaining the status of the original claim.