January 2020, Quarterly Release Temporary Hold

Each quarter, the Fiscal Intermediary Shared System (FISS) is updated to include new logic for claims processing, pricing, etc.

When the release is installed, Palmetto GBA places a temporary “hold” to ensure the release is installed properly. During this time, claims with dates of service of January 1, 2020, or later will be held in the status/location listed below and may be released before or on January 18, 2020, to continue processing.

Reason Code Location Status Status Description
 36452  SMHOSP Hospice
 37230  SMHOME Home Health Prospective Payment System (PPS) Claims
 WW999  SMFISS Holds All Claims

This process does not apply to home health requests for accelerated payments (RAPs) or hospice notices of election (NOEs).

Providers should be reminded that Medicare claims processed by the 30th day from claim receipt are considered timely. Beginning on the 31st day from receipt, interest will be applied to claims that have not been processed.

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