Are providers ready to send itemized statements?

As of last month, the federal government began requiring most Medicare carriers and fiscal intermediaries to print Advisory On Benefit Statements, which tell patients of their right to request an itemized statement. The Health Care Financing Administration (HCFA) in Baltimore is warning physicians, hospitals, and providers to be ready to send out such itemized statements free of charge when requested.

The new policy, part of the Balanced Budget Act of 1997, was designed to help Medicare beneficiaries understand their statements so they can more readily report suspicions of fraud, waste, and abuse. Providers and suppliers have 30 days from the receipt of a request to provide information such as a description of services provided, the date of service, provider/supplier charges, an internal tracking number, and a telephone contact for more information. (For more information, see DRG Coding Advisor, p. 71.)

The deadline for printing advisories on benefit statements has been delayed until July 1 for the Arkansas Part A Standard System. The deadline to begin providing the itemized statements has been pushed to July 1 for Medicare Part A institutional providers in Alaska, Maine, New Hampshire, New Jersey, North Carolina, Vermont, and Washington, and for those served by FI Mutual of Omaha.