Pending and Recycling the Claim When All Lines Do Not Have

100.5.5 - Pending and Recycling the Claim When All Lines Do Not Have a Match (Rev. 866, Issued: 02-17-06, Effective: 07-01-06, Implementation: 07-03-06) If the designated A/B MAC (B) receives a claim from the vendor and CWF determines some or all of the lines on the claim do not have a match, the designated A/B MAC (B) shall pend the claim for 90 days. However, prior to the end of the 90 day period, if at the vendor’s request the designated A/B MAC (B) can determine that a matching paper physician claim is on file, the designated A/B MAC (B) shall allow payment of the approved services on the claim. The designated A/B MAC (B) may also recycle the claim back to CWF at their discretion to determine if a matching electronic claim has been received prior to the end of the 90 day period. No interest shall be paid on the pending claim.