How Do I File Home Health and Hospice Claims to Medicare?
- File via Electronic Claim Media (EMC): Most facilities submit claims electronically or employ a clearinghouse to submit claims electronically for them.
- File via Direct Data Entry (DDE): Providers may manually use direct data entry (DDE) to submit their claims directly into the Fiscal Intermediary Shared System (FISS). However, the DDE program is usually used in tandem by facilities that electronically submit claims because of the functionality it offers. Providers are able to access various files, correct returned claims, see reports, check their financial claim summary and see the status and location of their processing claims.
- File using PC-ACE PRO32: CMS required Medicare Administrative Contractors (MACs) to offer free billing software to providers. Small providers may download the free PC-ACE PRO32 software to submit and manage their claims.
- File via Paper: Some providers that meet exceptions to mandatory electronic billing are allowed to submit CMS-1450 paper claim forms. To see if you qualify for an exception, please reference page six of the The Medicare Learning Network (MLN) Booklet Medicare Billing Form CMS-1450 and the 837 Institutional.
For more information on timely filing, including the limited exceptions to the 12-month timely filing period, see IOM Pub. 100-04, Chapter 1 (PDF, 1.62 MB), Section 70 - Time Limitations for Filing Part A and Part B Claims.
For information on submitting a request for a timely filing extension, see Checklist for Timely Filing Extension.