Checking Your Medicare FFS Claim Status

With the recent transition to ICD-10, you may wonder how soon you will know whether your Medicare fee-for-service (FFS) claim was paid.  Generally speaking, Medicare FFS claims take several days to be processed and must also– by law–wait 2 weeks before payment is issued.

You can check your Medicare FFS claim status by:

  1. Interactive Voice Response (IVR): IVR gives providers access to Medicare claims information through a toll-free telephone number. Visit your Medicare Administrative Contractor (MAC) website for information on the Provider Contact Center and IVR user guide.
  2. Customer Service Representative (CSR): Visit your MAC website for information on the Provider Contact Center only if you are unable to access claims information via IVR.
  3. MAC portal: Visit your MAC website for portal features and access.
  4. Direct Data Entry (DDE): Providers that bill institutional claims are also permitted to submit claims electronically via DDE screens. Visit your MAC website for more information.
  5. ASC X12: The ASC X12 Health Care Claim Status Request and Response (276/277) is a pair of electronic transactions you can use to request the status of claims (via the 276) and receive a response (via the 277). Visit your MAC website for more information.

Keep up to date on ICD-10. Visit the CMS ICD-10 website and Roadto10.org for the latest news and resources, including the ICD-10 Quick Start Guide.



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