Changes To Your CCR

If you have a New Provider Number you can expect Changes To Your CCR

Your CCR or cost to charge ratio will still be used with the surviving provider number if your hospital merges with another one. Your Medicare fiscal intermediary will continue to use the old CCR instead of a new one if there is a merger. However, If Medicare issues the hospitals a new provider number after a merger then there will be a different outcome.

In the event of a new provider number your Medicare fiscal intermediary will use the average CCR for the state because according to them a new provider number means that there has been the creation of a new hospital. You can request that your fiscal intermediary use a lower or even a higher CCR but you have to provide them with adequate evidence to support your request for that.

The CMS has stated that anything consumers want to have changed in this regard by their fiscal intermediary they must provide substantial evidence to back themselves up. The CMS has issued a November 7th, 2006 date in which the changes in FI’s CCR calculation methods will take effect.

Keeping up with the constant changes in the realm of medical coding and billing can seem daunting, if you want more time to run your practice and not keep ordering coding books for your staff to review and update, think about outsourcing your medical billing to a professional firm. It’s their job to keep up with the changes, make sure your documentation is always in place and be certain that you get the best reimbursements possible for procedures performed in your busy practice.

View all Articles by: Melissa Clark, CCS-P