Held Up Medical Billing Claim? It Might Be the Zip Code

At the beginning of 2007; medical billing claims that are submitted to Medicare for reimbursement need to have a zip code or you can count on a delay. A National Provider Identifier requirement to include your zip code on all billing transactions took effect Jan. 1. This included all bills including RAPs, and providers must report a five or nine-digit zip code for their primary facility and its subparts.

Claims without the zip codes will be returned to provider (RTP’d) with reason code 32114. This will affect any facility that does medical billing claims for Medicare reimbursement. Many providers were unaware of the new requirement and a large amount of medical billing claims have already been rejected with reason code 32114 in the first 2 weeks of January.

If you handle your own inhouse medical billing claims,make sure your staff knows to double check that the zip code is included or you’ll be part of the large number of facilities receiving rejected claims with reason code 32114. If you’re tired of keeping up with the little changes like this that can cause you revenue flow to slow to a trickle; it may be time to consider outsourcing your medical billing claims.

View all Articles by: Kathryn Etienne, CCS-P