Duplicate Billing Denials

NHIC issues its largest volume of denials for duplicate billings. The handling of these services is expensive to both providers and the Medicare program. NHIC strongly discourages providers from configuring their systems to automatically rebill outstanding claims after 30 days. Electronic claims are settled after 14 days while paper claims are settled after 28 days. NHIC recommends providers build edits into their systems to avoid duplicate submissions. NHIC encourages providers to stay current with posting every claim from their remittance advice(s) into their system, including denials. If a procedure is performed multiple times on the same day, use ICD-9-CM codes, modifiers and documentation to identify different sites, sessions or specimens.