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  • Posting Date: 06/06/2023
    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 [...]

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  • Posting Date: 06/06/2023
    Methods for Submitting an ADR

    Methods for Submitting an ADR Table of Contents Submitting Documentation NGSConnex Mailing an ADR CD/DVD esMD Fax [Return to Top] Submitting Documentation NGSConnex is the preferred method of submission. National [...]

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  • Posting Date: 06/06/2023
    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 [...]

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  • Posting Date: 06/06/2023
    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 [...]

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  • Posting Date: 11/25/2024
    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 [...]

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  • Posting Date: 12/02/2024
    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 [...]

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  • Posting Date: 12/02/2024
    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 [...]

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  • Posting Date: 11/26/2024
    Counseling to Prevent Tobacco Use

    In an effort to raise awareness and increase utilization of tobacco use counseling, we’ll focus on the effects of nicotine dependence including affected health consequences during this webinar. Medicare coverage, coding, billing and [...]

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  • Posting Date: 10/24/2018
    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 [...]

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  • Posting Date: 07/01/2024
    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 [...]

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  • Posting Date: 10/19/2021
    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 [...]

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  • Posting Date: 12/02/2024
    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 [...]

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  • Posting Date: 11/27/2024
    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: [...]

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  • Posting Date: 12/02/2024
    Off-label Use of Rituximab and Rituximab Biosimilars

    Off-label Use of Rituximab and Rituximab Biosimilars L39297 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=39297 A59101 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=59101 A59213 [...]

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  • Posting Date: 12/02/2024
    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 [...]

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  • Posting Date: 12/04/2024
    Flu, COVID-19 and PPV Vaccines

    During this webinar, we'll review the coverage, coding and billing guidelines for influenza, pneumococcal and COVID-19 vaccine administration and billing.

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  • Posting Date: 07/01/2024
    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 [...]

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  • Posting Date: 12/03/2024
    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 [...]

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  • Posting Date: 12/03/2024
    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 [...]

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  • Posting Date: 12/03/2024
    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 [...]

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