How to Find and Respond to TPE ADR

How to Find and Respond to TPE ADR Once you receive notification your facility is being placed on medical review, you’ll receive instructions on how to find the ADR. The ADR is a request to submit documentation for review to ensure proper [...]

Results Letters

Results Letters After National Government Services reviews the requested claims for your facility/office, you’ll receive a Results Letter with results from that round of TPE review. The Results Letter will contain the number of claims that [...]

Appeals

Appeals Appeals Overview Providers, suppliers and beneficiaries may appeal claim determinations made by National Government Services. The appeals process aims to ensure the correct adjudication of claims. The CMS governs appeals activities [...]

LCD and Article Updates for November 2024

LCD and Article Updates for November 2024 Local Coverage Determinations and Billing and Coding Articles The following Local Coverage Determinations and Billing and Coding Articles have been finalized and will become effective on the specific [...]

Get Help Completing My Enrollment Application

Since your organization can apply for Medicare enrollment in two ways, online through the PECOS system and on paper, it is important to know where to go to learn about the expected processes and guidelines. There are two main areas where you [...]

Get Help Completing My Enrollment Application

Since your organization can apply for Medicare enrollment in two ways, online through the PECOS system and on paper, it is important to know where to go to learn about the expected processes and guidelines. There are two main areas where you [...]

Initiate Part B Reopenings or Non-MSP Overpayment Adjustments in NGSConnex

Initiate Part B Reopenings or Non-MSP Overpayment Adjustments in NGSConnex Did you know that you can save time and money by requesting a Part B clerical error reopening electronically via NGSConnex? You will save time because electronic [...]

17729 and 17730 Hospice Claim Edits for Certifying Physicians

17729 and 17730 Hospice Claim Edits for Certifying Physicians Effective for hospice claims with claim ‘From’ dates on or after 6/3/2024, new claim edits have been implemented per CR 13342 to enforce CMS’ rule to deny hospice claims if the name [...]

How to Determine if the Provider is Active and Get the Provider Enrolled in Medicare Part B

How to Determine if the Provider is Active and Get the Provider Enrolled in Medicare Part B Table of Contents Determine if the Provider Has an Active Enrollment How to Enroll the Provider in Medicare Part B [Return to Top] Determine [...]

Get Help Completing My Enrollment Application

Since your organization can apply for Medicare enrollment in two ways, online through the PECOS system and on paper, it is important to know where to go to learn about the expected processes and guidelines. There are two main areas where you [...]

MLN Connects® Newsletter: November 27, 2024

MLN Connects® Newsletter: November 27, 2024 News Opioid Treatment Programs: CY 2025 Updates HIV Screening & Prevention Claims, Pricers, & Codes Home Health Prospective Payment System Grouper: January Update Clotting Factor: [...]

How to Determine if the Provider is Active and Get the Provider Enrolled in Medicare Part B

Table of Contents Determine If the Provider Has an Active Enrollment How to Enroll the Provider in Medicare Part B Determine If the Provider Has an Active Enrollment Navigate to the Medicare Fee-For-Service Public Provider Enrollment [...]

The Utilization of the KX Modifier on Dental Claims

The Utilization of the KX Modifier on Dental Claims National Government Services wants to bring to your attention the usage of the KX modifier for the submission of Medicare claims for dental services that are inextricably linked to covered [...]

Rural Tobacco Disparity

Rural Tobacco Disparity Tobacco use and exposure to SHS are major causes of preventable disease, disability and mortality in the United States and are responsible for approximately 480,000 deaths annually; another 16 million people are living [...]

Behavioral Health Telehealth In-Person Requirements

Behavioral Health Telehealth In-Person Requirements National Government Services has been receiving questions regarding the behavioral health telehealth requirement that the initial telehealth service include an in person visit within the [...]

Report a Change of Ownership, Acquisition/Merger or Consolidation

Table of Contents Step 1: Determine You Are in the Right Place Step 2: Understand Type of CHOW Change of Ownership Acquisition/Merger Consolidation CHOW Reminders Step 3: Make Changes via Enrollment Application Change of [...]

December 2024

In This Issue National Government Services Articles for Part A and Part B Providers Two Weeks to Prepare to Use NGSConnex for Beneficiary Eligibility Information A/B DME MAC Collaborative Lower Limb Orthoses Webinar November is Lung [...]

Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025

Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025 Table of Contents Provider Enrollment: Announcement About Medicare Participation for Calendar Year 2025 Advantages of Being a Medicare-Participating [...]

Medicare Participating Physician or Supplier Agreement Form (CMS-460)