Shared Systems Medicare Secondary Payer (MSP) Balancing Edit and Administrative Simplification Compliance Act (ASCA) Enforcement Update
Shared systems must reject inbound Medicare
Secondary Payer claims if the total of the paid amounts and the adjusted amounts does
not equal the billed amounts at the line level, the claim level, and if the claim lacks
standard claim adjustment reason codes to identify the adjustments performed. As part of
ASCA enforcement, contractors must be able to terminate a provider's paper claim denial
indicator if the provider submits documentation at any time to establish that they meet
criteria for submission of paper claims.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 02, 2006
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