Medicare Accelerated/Advance Payments Program for Enrolled Providers
The Centers for Medicare & Medicaid Services (CMS) announced expansion of its accelerated/advance payments program [PDF] to a broader list of suppliers, including audiologists and SLPs, during the COVD-19 pandemic. This opportunity could help clinicians offset some of the financial impact they are experiencing during the pandemic.
Accelerated and advance payments help offset financial losses during a national emergency or disaster.
An accelerated/advance payment provides necessary funds when there is a disruption in claims submission and/or claims processing. These expedited payments can be offered during national emergencies or natural disasters in order to accelerate cash flow to the impacted health care providers and suppliers. CMS provides accelerated/advance payments during the period of the public health emergency to any Medicare provider/supplier who submits a request to the appropriate Medicare Administrative Contractor (MAC) and meets the required qualifications.
CMS will use historic claims data for the clinician to determine the amount of the payment.
CMS has established specific eligibility criteria for these payments.
To qualify for advance/accelerated payments the provider/supplier must:
- have billed Medicare for claims within 180 days immediately prior to the date of signature on the provider’s/supplier’s request form;
- not be in bankruptcy;
- not be under active medical review or program integrity investigation; and
- not have any outstanding delinquent Medicare overpayments.
Providers can request up to three months of payments but must be prepared to repay Medicare within 210 days.
Medicare providers can request up to three months of accelerated/advance payments. CMS intends to process payments within seven days of application to the MAC. However, providers must repay Medicare within 210 days of receipt of the accelerated/advance payments. As a result, clinicians need to determine if these payments make financial sense considering the revenue they may or may not be generating to repay Medicare during this time.
Do not submit a claim after receiving an accelerated/advance payment.
If you received an accelerated/advance payment for three months and are then paid for one or more claims submitted during this period, CMS will recoup the amount of the claim(s) after 120 days.
Clinicians should apply for an accelerated/advance payment with their MACs.
Application forms are available on each MAC's website [PDF]. Although electronic submissions can reduce processing time, requests can also be submitted to the appropriate MAC by fax, email, or mail.
Clinicians should include the following information on the application:
- Provider/supplier identification information:
- Legal Business Name/ Legal Name
- Correspondence Address
- National Provider Identifier (NPI)
- Other information as required by the MAC
- Amount requested based on your need: Most providers and suppliers will be able to request up to 100% of the Medicare payment amount for a 3-month period.
- Reason for request:
- Select box 2 for “Delay in provider/supplier billing process of an isolated temporary nature beyond the provider’s/supplier’s normal billing cycle and not attributable to other third-party payers or private patients.” and
- State that the request is for an accelerated/advance payment due to the COVID-19 pandemic.
You can review a sample accelerated/advance payment request form [PDF], but remember, each MAC has their own form. For additional information, review the American Medical Association's advance payment FAQs.
Questions?
For questions regarding the accelerated/advance payment application process, contact your local MAC [PDF]. For general questions about audiology and speech-language pathology Medicare services, contact reimbursement@asha.org.
Please continue monitoring ASHA’s COVID-19 updates page for new information and resources.
