Is the GY modifier required on the drug code and the administration code for noncovered self-administered drugs?

Do all established drug HCPCS codes require the dosage amount in its description on the claim?

Navigating Skilled Nursing Facility Inpatient Billing Situations

During this session, we’ll explore how to properly bill situations that occur with skilled nursing facility inpatients such as; when the beneficiary did not meet the technical or medical requirements for coverage, has insurance primary to [...]

Skilled Nursing Facility Consolidated Billing

Did you know that skilled nursing facilities (SNFs) are responsible for paying outside entities for most services provided to beneficiaries while they are in a covered Part A stay and for certain services for Part B beneficiaries? Streamline [...]

MEDICAL REVIEW: Why did I receive a Comparative Billing Report?

MEDICAL REVIEW: Where can I find more details about the reasons my claims were denied?

MEDICAL REVIEW: Where can I get answers to billing questions?

MEDICAL REVIEW: What mailing address does NGS use to send Medical Review additional documentation requests (ADRs) to providers?

MEDICAL REVIEW: What constitutes a valid signature?

MEDICAL REVIEW: We are a large group and could potentially have many providers on TPE review. We have difficulty managing the process for each provider. Does NGS have any guidance for large groups?

MEDICAL REVIEW: The Medical Review Department did a post payment review of my Medicare claim and it was denied. How do I pay the money back to NGS Medicare?

MEDICAL REVIEW: My claim was reopened or adjusted by Medical Review. Does this impact the appeal window?

MEDICAL REVIEW: My claim was denied “56900 Documentation not received”; however, I did send in documentation. What now?

MEDICAL REVIEW: How do I respond to an ADR Not In List?

MEDICAL REVIEW: How do I sign up for the CMS and NGS Listserv messages?

MEDICAL REVIEW: I’m appealing my claim but received a letter to recoup funds from the TPE denial. What do I do about these letters?

MEDICAL REVIEW: I am under TPE review and my claims were denied, who can I speak to about this?

MEDICAL REVIEW: How do I request an appeal on a claim reviewed by the Medical Review Department?

MEDICAL REVIEW: How do I change my address and which address exactly am I changing to ensure receipt of the MR letters and ADRs?

MEDICAL REVIEW: How do I appeal a claim that MR reviewed but went to a T status or R status because of a CWF issue after MR processed?

MEDICAL REVIEW: How can I use NGSConnex to respond to Medical Review additional documentation requests?

MODIFIERS: When should the QW modifier be appended?

MODIFIERS: When should modifier 51 be added to a claim?

MODIFIERS: When is it appropriate to append the AQ modifier?

MODIFIERS: When is modifier 50 used?

MODIFIERS: When do I need to append the 99 modifier?

Where is the written Part B Reopening Form located?

What is timely filing to adjust a claim?

Where are the appeal forms?

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

Additional Events Links

Resources Education Partnership Request Form Five Steps to Webinar Success Provider Outreach and Education Reminders

What is the receipt date of the claim?

What is the timely filing for an appeal?

What is the refund address?

What is timely filing for a claim?

What is the mailing address for submitting a claim?

What is the denial date?

What is the address to send the QIC appeal?

What is the QIC timely filing limit?