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Are you submitting claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries?

8/13/2017 HealthWare Other 0 Comments

Date: August 4, 2017

SUBJECT: Suppression of the Standard Paper Remittance Advice (SPR) in 45 Days if also receiving Electronic Remittance Advice (ERA)

EFFECTIVE DATE: January 1, 2018 *Unless otherwise specified, the effective date is the date of service. IMPLEMENTATION DATE: January 2, 2018


A. Background: The SPR is the hard copy version of an ERA. Parts A and B Medicare Administrative Contractors (A/B MACs) and Durable Medical Equipment (DME) MACs must be capable of producing SPRs for providers/suppliers who are unable or choose not to receive an ERA. The A/B MACs and the DME MACs suppress distribution of SPRs if an Electronic Data Interchange (EDI) enrolled provider/supplier is also receiving ERAs for more than 31 days for Institutional Health Care Claims (837I) and 45 days for DME and Professional Health Care Claims (837P). Internet-Only-Manuals (IOMs), Medicare Learning Network (MLN) number MM4376, CR4376 and CR8570 resources have been provided with information to the A/B MACs and the DME MACs regarding the receipt of SPR and ERA distribution time lines.

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