The Centers for Medicare and Medicaid Services (CMS) published a last minute update to the “exact match” requirements ahead of today’s expected implementation date. Effective June 28, 2019, CMS stated they are postponing the full production implementation for three months until October 2019. CMS did confirm that their “Round 3” testing of the exact match protocols were completed and successful based on its analysis to date.
Notwithstanding, CMS did not clarify whether its stated delay of “full production implementation” means MACs may be allowed to activate the exact match protocols in advance of CMS’ stated October deadline. Advis is working to clarify this point with CMS and the MACs. However, it does appear that CMS is providing a welcome grace period for providers to complete required enrollment and billing system updates to ensure claims with service facility addresses reported in loop 2310E of the 837I transaction exactly match a practice location address enrolled on the hospital’s 855A.
Advis recommends providers use the additional time to complete updates in processing, confirm updates are accurate, and leverage this opportunity to ensure their enrollment and billing records/processes align with correlated provider-based rules and regulations.
Please contact Advis for assistance.