Waiver Pre-Approval

Medicare sometimes waives the ASCA electronic billing requirement, but you need pre-approval to submit paper claims in these situations:

• Any situation where you can show that an applicable HIPAA claim standard doesn’t allow you to submit a particular type of claim electronically
• Disability of all members of your staff prevents using a computer to submit claims electronically
• Other rare situations that CMS can’t anticipate where you can prove that due to conditions outside of your control, it would be against equity and good conscience for CMS to enforce this requirement

To request a waiver, send a letter with documentation proving your request’s validity to your MAC. It’s your responsibility to submit the correct documentation for the waiver request.