'Noncompliant' claims won't be paid as of Oct. 1.(Practice Trends)

Hello, October -- goodbye, paper Medicare claims.

Oct. 1 marks the date that physicians and other providers may no longer submit any paper Medicare claims; electronically filed claims not in compliance with federal regulations also are prohibited.

The rules are part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). After Oct. 1, paper claims will not be allowed; all electronic claims "that do not meet standards required by [HIPAA] will be returned to the filer for resubmission as compliant claims," the Centers for Medicare and Medicaid Services (CMS) announced in a statement. "Noncompliant claims will not be processed."

Paper claims will be accepted only from physician practices with fewer than 10 full-time employees and institutions with fewer than 25 full-time employees, according to a CMS spokesman.

As of June, only about 0.5% of Medicare fee-for-service providers were submitting noncompliant claims, CMS said.

But that figure is a little misleading, according to Rob Tennant, senior policy advisor at the Medical Group Management Association. "That doesn't mean [all] practices are submitting electronically. They're just getting claims to CMS electronically," he said. "Lots of times, providers will utilize a clearinghouse" that takes providers' paper claims and transfers them into an electronic format for submission.

The CMS statement mentioned only-compliance rates for claim forms, Mr. Tennant added. Compliance is much lower for other electronic transactions, such as remittances, eligibility status inquiries, and claims inquiries. "These are all very important transactions from providers, and we're hearing from health plans and others that providers aren't there yet."