Fiscal Intermediary Standard System

Section 4: Getting Ready to Bill Medicare Fiscal Intermediary Standard System National Government Services utilizes FISS to process claims and maintain Medicare beneficiary information. Providers have access to this information through a [...]

Advance Beneficiary Notice of Noncoverage

Section 4: Getting Ready to Bill Medicare Advance Beneficiary Notice of Noncoverage An ABN is a written notice a provider gives to a Medicare beneficiary before items or services are furnished, when the provider believes that Medicare [...]

Prepare and Submit a Medicare Tertiary Claim

Table of Contents Prepare and Submit a Medicare Tertiary Claim Step 1: Determine When a Claim(s) Must be Submitted to Medicare Step 2: Check for MSP Insurer Information in Medicare’s Records Step 3: Prepare and Submit Medicare Tertiary [...]

Using Medicare Resources

Did you know all providers who submit claims to the Medicare Program are required to be familiar and comply with the most current Medicare billing and coverage guidelines? Where do you turn to learn about Medicare? You can find a variety of [...]

Fast Track Access

Fast Track Access You will be prompted for the fast-track access when you use a feature that requires provider authentication (NPI, PTAN, TIN). Features: Claim Status, Checks, Offsets, Pricing, Appeals You can obtain a code after you [...]

Fast Track Access

Fast Track Access You will be prompted for the fast-track access when you use a feature that requires provider authentication (NPI, PTAN, TIN).  Features: Claim Status, Checks, Remittance Statements, Patient Status, Appeal Status You [...]

General Information <8>

General Information <8> When General Information is selected, the IVR will present the caller with a submenu. Voice Touch-Tone Entry IVR Supplies Phone Numbers 1 Commonly requested telephone numbers [...]

Understanding Medicare Fraud and Abuse

Join this session to learn about fraud and abuse affecting providers and your Medicare patients that will increase your awareness of integrity issues and prevent potential fraudulent and abusive practices against the Medicare Program.

Reopening versus Redetermination

Reopening versus Redetermination Table of contents Reopening versus Redetermination Reopening Telephone Reopening Unit Redeterminations [Return to Top] Reopening versus Redetermination Understanding your next steps are very [...]

Use National Government Services Self-Service Tools to Maximize your Workload

Use National Government Services Self-Service Tools to Maximize your Workload Our PCC telephone lines are busiest at the beginning and end of each month, and this creates long wait times for providers trying to resolve claim payments, denials, [...]

Common Denials Guide for Diabetes Self-Management Training and Medical Nutrition Therapy

Common Denials Guide for Diabetes Self-Management Training and Medical Nutrition Therapy National Government Services, MAC for Jurisdiction K and Jurisdiction 6, continues to provide you with resources to help reduce the burden of claim [...]

Non-Appealable Situations with Medicare Advantage Plans - Make Sure Your Staff is Aware

Non-Appealable Situations with Medicare Advantage Plans - Make Sure Your Staff is Aware When a Medicare Beneficiary enrolls in a MA Plan, that MA plan takes the place of Traditional Medicare benefits. National Government Services is [...]

Prepare and Submit an MSP Claim

Table of Contents Step 1: Determine if an MSP Claim Must be Submitted to Medicare Step 2: Check Medicare’s Eligibility Files via NGSConnex to Determine if There's Other Insurance Primary to Medicare Step 3: Prepare the MSP (Partial-Payment [...]

Determine if Medicare is Primary or Secondary for a Beneficiary's Services

Table of Contents Determine if Medicare is Primary or Secondary for a Beneficiary's Services Step 1: Collect MSP Information from the Beneficiary During an MSP Screening Process Step 2: Check for Open MSP Records for a Beneficiary in [...]

APPEALS: I received a remittance advice with the message “this care may be covered by another payer per coordination of benefits.” Is this an appealable claim?

CO-109

Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in a MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare that [...]

CO-22

Avoiding/Correcting This Error During patient registration, it’s important for office staff to identify whether a beneficiary’s claims should be covered by other insurance before, or in addition to, Medicare. Providers shall [...]

CO-109

Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in a MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare that [...]

CO-22

Avoiding/Correcting This Error During patient registration it’s important for office staff to identify whether a beneficiary’s claims should be covered by other insurance before, or in addition to, Medicare. Providers shall use [...]

PR-31

Avoiding/Correcting This Error Services were denied for one or more of the following reasons: The name or Medicare number was incorrect or missing. The date of death precedes the date of service. Expenses were incurred prior to coverage. [...]