Appeals

Appeals Reopenings Telephone Reopening Unit Jurisdiction 6 Telephone Reopening Unit Contact Number Hours of Service Illinois 877-867-3418, Press 1 8:00 a.m.–4:00 p.m. CT Closed for training on the [...]

J6 Part B Applying for an Extended Repayment Schedule

Applying for an Extended Repayment Schedule

DRG (Pricer/Grouper) (11)

Chapter IV: Inquiries Submenu (01) DRG (Pricer/Grouper) (11) Purpose This option will be used by the provider to research PPS information as it pertains to an inpatient stay. To access the DRG (Pricer/Grouper) option from the FISS Online [...]

RSNAT Pre-Pay Review

RSNAT Pre-Pay Review The RSNAT PA program has two components, PAR or prepayment review, which suppliers are able to use their discretion on the path that best suits their workflow. If a RSNAT supplier chooses to forgo the PA process for [...]

Billing and Coding Article Update for August 2023

Billing and Coding Article Update for August 2023 Billing and Coding: Non-Invasive Vascular Studies (A56758) Effective 8/31/2023, the following ICD-10-CM codes were added to the "ICD-10-CM Codes That Support Medical Necessity" section (Group [...]

MLN Connects® Newsletter: August 24, 2023

MLN Connects® Newsletter: August 24, 2023 News Seasonal Flu Vaccine Pricing for 2023–2024 Season Expanded Home Health Value-Based Purchasing Model: July 2023 Interim Performance Reports, Post-Event Materials, & Comment on CY 2024 [...]

Unprocessable Claim Rejections and Corrections

Unprocessable Claim Rejections and Corrections Assigned and nonassigned services are considered unprocessable when incomplete or invalid information is detected in our claims processing system. Unprocessable claim is described in the CMS IOM [...]

Medicare Beneficiary Eligibility Checklist

Tip Sheet #1

National Government Services Office of Congressional Affairs Protocol: Tip Sheet #1 Medicare is changing and we live in a MAC world and this protocol explains the process to help you submit your Medicare constituent inquiries. Today, [...]