Medicare Changes Lead to Payment Delays for California Physicians
A change in the way Medicare handles claims and a switch to a new claims processor have led to a backlog of California physicians waiting for Medicare reimbursement payments, the Ventura County Star reports.
In May, CMS changed the way it handles basic claims by creating a national provider identifier for physicians to use when submitting applications for processing. Two months later, Medicare switched its claims processor from National Heritage Insurance to Palmetto GBA.
David Sayen, regional administrator of CMS Region 9, which includes California, said some of the late Medicare payments might have been caused by doctors using incorrect NPIs when filing claims. Â
Ned Wigglesworth, a spokesperson for the California Medical Association, said making two major transitions in a short period of time created a "perfect storm" for turmoil. He said, "The second transition compounded the first problem."
The delayed reimbursements have caused some physicians to begin turning away new Medicare patients.
"For some practices, if they haven't been paid even one to two months, it severely impairs their ability to pay their bills and buy the medication and equipment they need to run their office and take care of patients," Wigglesworth said, adding, "Unfortunately, [patients] end up suffering because the doctors have to take less Medicare patients" (Potkey, Ventura County Star, 10/6).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.