A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices

A/B DME MAC Collaborative Webinar: Positive Airway Pressure Devices Physicians/Practitioners! Are you Ordering PAP Devices for Your Patients? This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

Site Visits

Site Visits Site visits may be required for certain providers and will be unannounced; the contractor representatives must disclose to the provider appropriate identifying credentials and explain the purpose of the visit. CMS has implemented [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

Site Visits

Site Visits Site visits may be required for certain providers and will be unannounced; the contractor representatives must disclose to the provider appropriate identifying credentials and explain the purpose of the visit. CMS has implemented [...]

Requests for Additional Information

Requests for Additional Information While processing the application(s) National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

PECOS Self-Service Application Status

PECOS Self-Service Application Status You may run simple search queries to retrieve and view the status of your PECOS application. Individual View the enrollment application status of an individual provider in an organization or private [...]

Check Provider Enrollment Application Status

Check Provider Enrollment Application Status You may run simple search queries to retrieve and view the status of your CMS-855 application via two options. Case number/web tracker id NPI and TIN combination Related Content Check [...]

Interactive Voice Response System

Interactive Voice Response System You may check the status of your provider enrollment application (PECOS or paper) submission via the IVR by: Case number/web tracker id or NPI and TIN combination Related Content Interactive [...]

Dental Claim Cross Over

Dental Claim Cross Over Medicare contractors coordinate with the MSP Contractor, GHI, to automatically cross over claim payment information for their policyholders as a courtesy. An eligibility file furnished by the supplemental insurer is [...]

Three Ways to Protect Your Medicare Enrollment Information

Three Ways to Protect Your Medicare Enrollment Information Protect your enrollment information from Medicare fraud with these three steps: Keep your Medicare Provider Enrollment, Chain, and Ownership System (PECOS) user ID and password [...]

Help Prevent Bank Account Fraud

Help Prevent Bank Account Fraud The provider should be aware of the following to help prevent bank account fraud if no authorized individual from your entity submits a change to enrollment. Contact your MAC immediately if: remittances [...]

“Payer Only” Codes Submitted on Part A Medicare Claims

“Payer Only” Codes Submitted on Part A Medicare Claims This article is to inform Part A providers of an editing change impacting claims submitted with “payer only” codes. As of 7/3/2024, new edits cause claims to RTP when a “payer only” [...]

Provider Enrollment Appeals Process

Provider Enrollment Appeals Process Table of Contents Provider Enrollment Appeals Process Corrective Action Plans Requirements for CAP Submission Reconsiderations Requirements for Reconsideration Request Submission Related Content [...]

Rebuttal for Deactivation of Medicare Billing Privileges

Rebuttal for Deactivation of Medicare Billing Privileges Pursuant to 42 CFR, Section 424.545(b), a provider or supplier whose Medicare billing privileges have been deactivated may file a rebuttal in accordance with 42 CFR, Section 405.374. A [...]

Rebuttal for Deactivation of Medicare Billing Privileges

Rebuttal for Deactivation of Medicare Billing Privileges Pursuant to 42 CFR, Section 424.545(b), a provider or supplier whose Medicare billing privileges have been deactivated may file a rebuttal in accordance with 42 CFR, Section 405.374. A [...]

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction 6 HH+H Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Services - Medical Necessity ICD-10 Z47-Z47.89 N/A 55H3V– The documentation did [...]

Meeting Schedules

Meeting Schedule Part A POE AG Meetings for Jurisdiction 6 and Jurisdiction K J6: Illinois, Minnesota, Wisconsin and Federally-Qualified Health Centers in All States JK: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island [...]

837D Edit Spreadsheet

837D Edit Spreadsheet