URGENT - All Physicians Need To Be Financially Prepared to Withstand 2 TO 4 WEEKS WITHOUT MEDICARE PAYMENTS Due To Indiana Medicare's Transition to a New Financial Accounting System

By Joy Newby, LPN, CPC, PCS

When I read Indiana Medicare's Listserv article dated January 31, 2012, it
didn't seem to be that big of a deal! Boy, was I ever wrong! I failed to
click on the "review the HIGLAS transition letter" hyperlink. Now I
understand that all Indiana physicians and providers need to prepare
financially to withstand two (2) to four (4) weeks without Medicare
payments!

Indiana Medicare sent all Medicare physicians and providers a letter dated
February 1, 2012 outlining the steps necessary to transition to CMS' new
financial system. Of importance to members is the following section:

Temporary Waiver of the Claims Processing Payment Floor

CMS has approved National Government Services' waiver request to reduce the
payment floor for both paper and electronic data interchange (EDI) claims.
Beginning on March 6, 2012 payment cycle, payments will be released
gradually for claims that have already been approved for payment. [Emphasis
added]

*          March 6, 2012: Payment floor reduced to 7 days for EDI claims and
14 days for paper claims.

*          March 7, 2012: Payment floor reduced to 0 days for EDI claims and
0 days for paper claims.

This temporary reduction of the payment floor will result in payments being
issued early for both checks and Electronic Funds Transfers (EFTs). This may
give the appearance that your cash revenues have increased when in fact you
received payments for some of your claims earlier than normal. Providers are
encouraged to monitor their payments and make adjustments, as necessary to
prevent cash flow problems during the transition period. [Emphasis added]

Depending on whether you are on EFT or are still receiving paper checks,
please realize that while your cash flow will increase around March 8 and 9,
due to the release of all claims for payment, you are going to experience a
lean period because you will not be able to submit new claims beginning
March 8th through March 11th (and March 12 may be a "dark day" as well
depending on how easy the transition goes).

Further, when Indiana Medicare begins accepting new claims on March 12 (or
March 13), the payment floors will once again be in full force

*          Electronic claim submitters will experience a significant
reduction in payments from March 13 through March 21 because regular
payments on electronically submitted claims will not be made during these
dates!!

*          Paper claim submitters will experience a significant reduction in
payments from March 13 through April 5 because regular payments on paper
claims will not be made during these dates!!

A copy of the "Dear Provider" HIGLAS transition letter has been posted here.