Important Information Concerning Medicare Outreach Efforts to Supplemental Payers Directing Their Payments to Incorrect Addresses

Many physician/practitioner billing offices have notified their A/B MAC or Part B Carrier and CMS that various supplemental payers have directed payment, from Medicare crossover claims, to incorrect payment addresses. The problem appears to have escalated as the supplemental payers have transitioned from receipt of crossover claims in version 4010A1 837 professional claims format to the version 5010A1 837 professional claims format. There is a CMS directive to Medicare fee-for-service contractors that governs the reporting of provider address information that must appear on outbound crossover claims. Medicare contractors are to populate both the Bill-to Provider and Pay-to Provider with information retained within PECOS and within the internal Medicare claims processing systems’ physician/practitioner, supplier, and provider files. This means that the Bill-to and Pay-to Address information reported on incoming claims to Medicare will not be what will be included on outbound Medicare crossover claims. Physicians/practitioners, suppliers, and providers need to ensure that Medicare has the most up-to-date address information, check and remittance advice (or Pay-To) address information correctly on file for their various offices.