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MLN Provider Compliance

The Medicare Learning Network

Fast Fact

Submitting duplicate claims for the same service encounter is inappropriate. Medicare does not make payment for duplicate claims that a provider may submit. CMS will pay the first claim that is approved and will deny subsequent claims for the same service as duplicates. Although Medicare is prohibited by law from paying claims immediately, over 90 percent of clean, payable claims are paid within 30 days.  Refer to the Medicare Quarterly Provider Compliance Newsletter [Volume 5, Issue 2] for more information.

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The Medicare Learning Network® (MLN) Provider Compliance page contains educational products that inform health care professionals on how to avoid common billing errors and other improper activities when dealing with various CMS Programs. CMS’ claim review program’s overall goal is to reduce improper payment error by identifying and addressing coverage and coding billing errors. Since 1996, CMS has implemented several initiatives: to prevent improper payments before a claim is processed; and to identify, and recoup improper payments after the claim is processed.

The Downloads section contains MLN products, MLN Matters® Articles, and the “Archive of Medicare Quarterly Provider Compliance Newsletters” which have been designed to provide education on common billing errors and other improper activities. These lists, as well as other information in the Downloads and Related Links section, are updated as new products and articles are developed and existing products and articles are revised.

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