Quarterly Credit Balance Reports No Longer Required

Quarterly Credit Balance Reports No Longer Required As of 12/1/2024, providers are not required to submit the Medicare Credit Balance Report (CMS-838) on a quarterly basis. However, to ensure that monies owed to Medicare are repaid in a timely [...]

Submitting a Prior Authorization Request

Submitting a Prior Authorization Request Table of Contents Submitting a Prior Authorization Request Documentation Requirements Documentation Checklist for Medical Professionals Supporting the Physician Certification Statement [Return [...]

Meeting Schedules

Meeting Schedules Jurisdiction 6: Illinois, Minnesota, Wisconsin Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Meeting Date/Time Provider Type Chairpersons [...]

National Government Services - Telehealth Extension 2025

National Government Services - Telehealth Extension 2025 Section 3207 of the American Relief Act, 2025 modified Section 1834(m) of the Social Security Act to extend the waiver of the geographic, site of service, and practitioner type [...]

J6 Part A

J6 Part A Member Name Facility State Albaitis, Susan DaVita Kidney Care Multiple states (ESRD) Anderson, Brian Advocate Aurora Illinois Anderson, Keith Southern Illinois Healthcare [...]

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year The Hospice Cap Self-Reporting for the 2024 Cap Year (10/1/2023–9/30/2024) is due no later than 2/28/2025. Hospice providers should submit the pro-forma calculation along with [...]

Hospice Cap Self-Reporting

Hospice Cap Self-Reporting Table of Contents Hospice Cap Self-Reporting Cap Year (10/1/XXXX–9/30/XXXX) Completing the Pro-Forma Submitting the Pro-Forma Repaying an Overpayment Requesting an Extended Repayment Plan [...]

Federally Qualified Health Center (All States)

Federally Qualified Health Center (All States) Member Name Facility State Banks, Amy Health Access Network, Inc. Maine Boyd-Gamson, Terry Santa Barbara County Public Health California [...]

Part A Content

Cost Report Contacts: IL, MN, WI, All FQHC: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME J6_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: Cost [...]

Part A Content

Cost Report Contacts: CT, ME, MA, NH, NY, RI, VT: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME JK_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: [...]

Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients?

Clinicians: Are You Ordering Ankle-Foot/Knee-Ankle-Foot Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a lower limb orthosis to your patient. Medicare must be able to verify that there [...]

PA RSNAT Coversheet

Medicare Part A

Section 2: Medicare Basics Medicare Part A Table of Contents Medicare Part A Benefit Periods—Medicare Part A Ending a Benefit Period Benefit Period Examples [Return to Top] Medicare Part A Medicare Part A is referred to as Hospital [...]

Clinicians: Are You Ordering Knee Orthoses for Your Patients?

Clinicians: Are You Ordering Knee Orthoses for Your Patients? The DME MACs are providing helpful guidance to assist suppliers in providing a knee orthosis to your patient. Medicare must be able to verify that there is medical record [...]

MLN Connects® Newsletter: January 8, 2025

MLN Connects® Newsletter: January 8, 2025 News Medicare Part B Vaccine Administration: CY 2025 Payment Amounts Historically Excepted Tribal Federally Qualified Health Centers: CY 2025 Payment Rate DMEPOS: Adding New Product Category to [...]

Fourth Quarter Top Ten EDI Part B Edits

Fourth Quarter Top Ten EDI Part B Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Part B Edits to view the edits, their description and learn what you can do to correct [...]

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting tobacco use presents various challenges for patients, and staying motivated can be difficult. All health care providers, especially those with direct patient contact, have a unique opportunity to [...]

31605

Avoiding/Correcting This Error The occurrence span code 77 should only be used to indicate the span of days that were not covered on claims. Related Content Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77  

7C625

Avoiding/Correcting This Error Hospice – Clarify reason for discharge. Claim is being returned for one of the following reasons: Remarks are not present or do not indicate valid reason for discharge/transfer. Remarks indicate beneficiary [...]