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Posting Date: 08/24/2023
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 [...]
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Posting Date: 12/21/2020
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 [...]
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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, [...]
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Posting Date: 10/29/2018
Multi-Factor Authentication
Multi-Factor Authentication Multi-factor authentication (MFA) is a second layer of security required by CMS to have online access to protected health information. The MFA screen will display every time you log in to NGSConnex. Each day [...]
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Posting Date: 02/26/2022
View Remittance
View Remittance If you receive SPRs you will not be able to view remittance statements in NGSConnex. If you are signed up to receive an 835 ERAs or you have elected to view remittance statements through NGSConnex, you may view and print or [...]
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Posting Date: 02/26/2022
Change Your Password
Change Your Password Select the Manage Account button on the NGSConnex home page. Select User Profile. You must change your NGSConnex password at least once every 60 days. This is a CMS security requirement to have online access to [...]
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Posting Date: 04/15/2018
Processing Drivers and System Claim Paths
Chapter I: Online System Terminology Processing Drivers and System Claim Paths Purpose Claims that are filed through the FISS DDE Provider Online System follow a prescribed route referred to as a system claim path. Claim paths [...]
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Posting Date: 01/31/2019
Claim Status and Location Codes
Chapter I: Online System Terminology Claim Status and Location Codes Purpose The purpose of the status and location is to route claims through FISS. The status describes the general condition of the claim (i.e., whether paid, denied, [...]
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Posting Date: 01/29/2020
Inquiries Submenu
Chapter II: Online Menu Functions Overview Inquiries Submenu Purpose The INQUIRIES submenu allows providers to perform research through various file options, such as the following: Beneficiary/CWF information Claim status DRG [...]
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Posting Date: 01/29/2020
HCPCS Codes (14)
Chapter IV: Inquiries Submenu (01) HCPCS Codes (14) Purpose The purpose of the HCPC CODES option is to provide access to details related to the HCPCS codes available to be reported on a claim. HCPCS codes are five-digit alphanumeric [...]
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Posting Date: 02/25/2022
DX/Proc Codes ICD-9 (15)
Chapter IV: Inquiries Submenu (01) DX/Proc Codes ICD-9 (15) Purpose The purpose of the DX/PROC CODES ICD-9 option is to provide a reference of ICD-9-CM code(s) used to identify a specific or various diagnosis codes or inpatient surgical [...]
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Posting Date: 01/29/2020
Adjustment Reason Codes (16)
Chapter IV: Inquiries Submenu (01) Adjustment Reason Codes (16) Purpose An adjustment reason code is a two-digit alphanumeric code reported on a claim adjustment to identify the specific reason the claim is being adjusted. This option [...]
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Posting Date: 01/29/2020
Reason Codes (17)
Chapter IV: Inquiries Submenu (01) Reason Codes (17) Purpose FISS reason codes are five-digit alphanumeric codes that indicate the outcome of claim editing and processing. The REASON CODE option provides details to indicate why the claim [...]
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Posting Date: 01/30/2020
Claim Count Summary (56)
Chapter IV: Inquiries Submenu (01) Claim Count Summary (56) Purpose The CLAIM COUNT SUMMARY option provides a review of the total claim count and total dollar amount for claims pending in a specific location. This information is updated in [...]
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Posting Date: 01/30/2020
Invoice Number/DCN Translator (88)
Chapter IV: Inquiries Submenu (01) Invoice Number/DCN Translator (88) Purpose The purpose of the Invoice Number/DCN Translator screen is to allow the provider to identify a claim’s Invoice Number when the DCN is known. This option also [...]
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Posting Date: 01/30/2020
Community Mental Health Centers Services Payment Totals (1C)
Chapter IV: Inquiries Submenu (01) Community Mental Health Centers Services Payment Totals (1C) Purpose The purpose of the CMHC Payment Totals screen (MAP1D61) is to display the CMHC payment and outlier totals for current year and one [...]
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Posting Date: 01/30/2020
Provider Practice Address Query (1D)
Chapter IV: Inquiries Submenu (01) Provider Practice Address Query (1D) Purpose The purpose of the Provider Practice Address Query screen is to display the additional practice addresses for a facility; this includes off-campus, outpatient, [...]
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Posting Date: 03/23/2020
New HCPCS Screen (1E)
Chapter IV: Inquiries Submenu (01) New HCPCS Screen (1E) Purpose The purpose of the New HCPCS Screen (1E) is to provide information related to HCPCS pricing and allowable revenue codes related to HCPCS. HCPCS codes are five-digit [...]
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