CMS Requesting Information From Hospitals for “Exact Match” Implementation

CMS is requiring that hospitals validate practice locations in advance of full implementation of the “exact match” requirements (scheduled for April 2020 – see previous article). Many providers have received these notices from the MACs in recent weeks. We include a Sample Letter to assist with your preparation for completing this form accurately to avoid incurring future penalties.

MACs are seeking to verify the hospital practice location information as reported in the Medicare 855A enrollment record.  MACs are also directing the hospitals to identify the type of practice location for each site (e.g., on- vs. off-campus, remote location, emergency department, etc.). To date, MAC letters received by hospitals have included short turnaround times, and it is unclear whether there will be any penalties for non-compliance.  Therefore, for hospitals receiving these letters, Advis recommends immediately reviewing the attached information, updating the same (where necessary), and responding to the MAC to avoid potential unknown ramifications.

As a reminder, “exact match” will require that hospitals include the actual service facility address for certain hospital outpatient departments and remote inpatient locations in Loop 2310E of the 837I electronic institutional claims transaction.  These addresses must then exactly match to an address registered on the hospital’s Medicare 855A enrollment record.

Advis continues to recommend a full review of Medicare enrollment and billing records to ensure readiness for full production implementation of “exact match” in April, 2020. For more information on these requirements, or for assistance with implementation and/or review of your processes, contact our office at (708) 478-7030.

View the Sample Letter: