Enrollment and Eligibility (ENR) FAQ
Guidance for FAQ regarding Notices and Issuer Notices
Program Area: Enrollment and Eligibility (ENR)
Question: Do provider grace period notice letters need to be generated for every one of a subscriber's claims or can a single letter be generated by a provider for all subscribers that have delinquent claims for that provider practice?
Answer: It is required that the QHP Issuer inform each provider that an enrollment group is in a grace period, which may cause pended and/or denied claims. Guidance can be found in 45 CFR 45 156.270(d)(3) and Letter to Issuers dated 03/01/2013. Please see link below: http://www.ecfr.gov/cgi-bin/retrieveECFR?gp=1&SID=f9e5b775e5f27853e64952f600b8dcac&ty=HTML&h=L&r=PART&n=45y1.0.1.2.71#45:1.0.1.2.71.3.27.13
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 27, 2014
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