July 2019, Quarterly Release Temporary Hold

July 3, 2019

Each quarter, the Fiscal Intermediary Shared System (FISS) is updated to include new logic for claims processing, pricing, etc.
When the release is installed, Palmetto GBA places a temporary “hold” to ensure the release is installed properly. During this time, claims with dates on service of July 1, 2019, or later will be held in the status/location listed below and may be released before or on July 18, 2019, to continue processing.

Reason Code	Location Status	Status Description
36452	SMHOSP	Hospice
37230	SMHOME	Home Health Prospective Payment System (PPS) Claims
WW999	SMFISS	Holds All Claims

This process does not apply to home health requests for accelerated payments (RAPs) or hospice notices of election (NOEs).
Providers should be reminded that Medicare claims processed by the 30th day from claim receipt are considered timely. Beginning on the 31st day from receipt, interest will be applied to claims that have not been processed.