Medicare Payment Floor
The Medicare Payment Floor refers to the amount of time Wisconsin Physicians Service (WPS) has to finalize and process claims. Based on how you file claims, your Provider Remittance Notice (PRN) and check(s), if appropriate, will be issued after the pertinent timeframes. The Medicare Claims Processing Internet-Only Manual Publication 100-4, Chapter 1, Section 80.2.1.2 instructs WPS not to " . . . pay, issue, mail, or otherwise pay for any claim it receives from providers within the waiting period as indicated below. The length of the waiting period is determined by the date a claim is received. The carrier [WPS] starts its count on the day after the day of receipt." Messages may appear on the remittance notice and the beneficiary Medicare Summary Notice (MSN) if the claims information has been forwarded to the beneficiary's supplemental insurer.
- HIPAA-compliant Electronic Claims: 13 calendar days from claim receipt date
- Paper Claims: 29 calendar days from claim receipt date (Per Change Request (CR) 4284, read the CMS MLN Matters Article
related to this CR.)
Page Last Updated: Thursday, 04-Mar-2010 10:28:47 CST
