Medicare has formally asked Part D prescription drug plans to ease 30-day
billing limits and open claim submission windows for at least 90 days. Alluding
to system challenges in Part D implementation, especially errors with claim
adjudication, Medicare announced Feb. 7 that standard rejections based on claim
time should “be relaxed to allow pharmacists to bill Part D plans for claims
that are as old as 90 days.” Practically, this 90-day window will allow
pharmacists to resubmit incorrect claims without fear of non-payment due to
narrow claim submission times.
Monitor your plan remittance advice carefully. If you have not
received claims remittance advice along with your reimbursement checks, request
that a complete reconciliation be provided from your third party contracting
group or from the Part D plan directly.