The difference between Road and Rd., or Avenue and Ave. might seem small.

But even a small difference will soon have a big impact on your bottom line.

In Q3 of 2019, CMS will direct all MACs to permanently activate a “direct match” edit for all Part A claims submitted by hospital-owned provider-based departments (PBDs). This edit, known as the Return-to- Provider (RTP) edit, will require that all service addresses directly match the address as entered in PECOS.

Claims that do not exactly match will be returned to the provider.

Any variation could result in millions of dollars in claims being denied. Attend this brief informational session and learn how to:

  • Identify all outpatient provider-based departments at risk.
  • Identify rendering service locations as entered in claims processing systems.
  • Reconcile these with addresses entered into PECOS.
  • Ensure Exact Match in both systems.


Anna Arutyunyan

Vice President, CVO, Newport Credentialing Solutions,

Allyson Schiff

Vice President of Operations, Newport Credentialing Solutions,

CMS Compliance Update:

Return to Sender:
Mitigating Denied Claims with Exact Match

Wednesday, July 24
at 11:00 am ET/10:00 am CT
Thursday, July 25
at 1:00 pm ET/Noon CT