October 9, 2018
Part A Top Medicare Credit Balance Submission Rejects
Credit Balance (CB) reports are often rejected due to missing or invalid information. Analysis of rejected CB reports submitted for the quarter ending March 31 and June 30, 2018, showed the top reason for rejects was the reporting of an incorrect quarter end date.
The next Quarterly Medicare Credit Balance Report is due in our office postmarked by October 30, 2018. As you prepare your next CB report, please review the top three reasons for rejected CB reports and develop internal processes to prevent these types of rejects. Preventing these rejects will help you avoid possible payment suspension.
Reject Reason# 1 |
March 31 Quarter End |
June 30 Quarter End |
---|---|---|
Incorrect Quarter Ending Date |
27 |
83 |
The quarter ending dates are:
|
Reject Reason #2 |
March 31 Quarter End |
June 30 Quarter End |
---|---|---|
PTAN not our provider |
18 |
29 |
You may also review the claim on the Fiscal Intermediary Standard System (FISS) Direct Data Entry (DDE) screens. Each FISS DDE screen displays “CGS J15 MAC – Part A REGION” at the top. Research the FISS DDE screens to verify that the claim being reported on the CB Report is one that CGS processed. Refer to the Part A FISS Guide: Inquiry Menu Chapter 3 for information about checking the status of your claim. |
Reject Reason #3 |
March 31 Quarter End |
June 30 Quarter End |
---|---|---|
Certification date missing or incorrect |
10 |
16 |
|
For additional information, refer to the following resources on the CGS Part A website.