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Posting Date: 01/27/2021
RM 1-HHH_Who May File an Appeal
When Is an Appointment Not Necessary? If the requestor is the beneficiary’s legal guardian, surrogate decision maker for an incapacitated beneficiary, an SSA-appointed representative payee, or is otherwise authorized under state law, no [...]
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Posting Date: 03/22/2021
Dental Codes Billed As Principal Diagnosis Code Cause Claim Rejections
Claims Submitted With Dental Codes As Principal Diagnosis Will RejectOn 1/3/2021, EDI added a new edit to the EDI Front-End. If an 837I claim contains principal diagnosis code 2300 HI with qualifier ABK (principal diagnosis) that is a dental [...]
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Adjustment of Claims with Automated Medical Review Denials
Adjustment of Claims with Automated Medical Review Denials National Government Services would like to provide clarification to providers receiving automatic denials on claims. In certain circumstances it may be necessary to correct a billing [...]
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