High Volume of Paper Claims

A MAC sends letters to health care professionals or suppliers that submit high numbers of paper claims in the previous quarter.

After payment, MACs verify that health care professionals or suppliers meet the exception criteria to continue to submit paper claims. Providers submit an ASCA waiver request to their MAC.

Find your MAC’s website to locate the ASCA waiver. You can fax or mail the waiver to your MAC. If your MAC approves the request, it will send the request to CMS recommending ASCA waiver approval.

Approves your exception via a letter sent in the mail. You may submit paper claims.
OR
Denies your exception and all paper claims starting 91 calendar days after the denial letter date. You can’t appeal these decisions.

Your MAC will deny paper claims starting 91 calendar days after the first letter date asking for documentation. You can’t appeal these decisions.

If you submit justification to the MAC for an exception to submit paper claims, your MAC either:

If you don’t respond to a request for exception information:

Resources