Change to Roster Claims Information Entry in the Fiscal Intermediary Standard System Direct Data Entry

Change to Roster Claims Information Entry in the FISS DDE Effective 1/28/2013, the FISS maintainer has made a change to the way roster claims are entered. After entering the required information into the FISS DDE, providers will have to hit [...]

Common Working File (CWF) Host Dark Days for April 2024 Release

Common Working File (CWF) Host Dark Days for April 2024 Release For the upcoming April 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/28/2024 and Dark Days starting Friday, 3/29/2024 through Sunday, 3/31/2024 [...]

Proper Billing for Patient Supplied Drugs

Proper Billing for Patient Supplied Drugs Drugs, including biologicals, must represent an expense to the physician or legal entity billing for the services or supplies. In some instances, the patient purchases the drug or, the physician [...]

Evaluation and Management Frequently Asked Questions

Evaluation and Management Frequently Asked Questions We’ve expanded our E/M FAQs for the Complex and Chronic Care – HCPCS code G2211 category to include answers to common questions we’ve received about this add-on code. Visit this page for the [...]

MLN Connects® Newsletter: February 22, 2024

MLN Connects® Newsletter: February 22, 2024 News CMS Issues Additional Guidance on Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments Compliance Medical Services Authorized by the [...]

Correct or Reopen a Claim Due to an MSP-Related Issue

Table of Contents Correct or Reopen a Claim Due to an MSP-Related Issue Identify the Finalized Status of the Claim and Take the Appropriate Action Depending on the Type of Denial/Correction That Needs to be Made Step 1 Claim Denied as [...]

Medicare Part B Overpayments

Medicare Part B Overpayments We developed the Medicare Part B Overpayments Tip Sheet to provide instructions for reporting various overpayment situations. Topics include responding to a demand letter, viewing outstanding overpayments, [...]

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Overpayments Right Hand

Resources Medicare Part B Overpayments Tip Sheet Form(s) you'll need: Financial Contact Submissions All Forms

Ambulance Duplicate Claim Denials

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National Provider Identifier) [...]

Sample TPE Notification Letter

Sample TPE Notification Letter Mail Date Provider Name Provider Address City, State, Zip Casefolder ID: Casefolder ID Provider Number PTAN: PTAN (Provider Transaction Access Number) Provider Number NPI: NPI (National [...]

Medicare Preventive Services

Medicare Preventive Services Medicare covers many preventive services to help keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain [...]

LCD and Billing and Coding Article Updates for February/March 2024

LCD and Billing and Coding Article Updates for February/March 2024 Local Coverage Determinations Biomarker Testing for Prostate Cancer Diagnosis (L37733) This LCD has been retired and will no longer be in effect for services performed after [...]

Date of Service on CMS-1500 Billing

Date of Service on CMS-1500 Billing Overview Radiology Services Surgical and Anatomical Pathology Chronic Care Management Care Plan Oversight Home Health Certification and Recertification Physician End-Stage Renal Disease Services [...]

Change Healthcare Security Incident

Change Healthcare Security Incident The CMS and National Government Services are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connects providers with insurance payers and has [...]

MLN Connects® Newsletter: February 29, 2024

MLN Connects® Newsletter: February 29, 2024 Events ICD-10 Coordination & Maintenance Committee Meeting — March 19–20 MLN Matters® Articles Appropriate Use Criteria for Advanced Diagnostic Imaging: CY 2024 Update Clinical [...]

Tobacco Counseling via Telehealth

Tobacco Counseling via Telehealth Tobacco use is the leading cause of preventable disease, disability and death in the United States. Each year, nearly half a million Americans die prematurely of smoking or exposure to secondhand smoke. [...]

You Asked, We Listened: Redesigned Events Page Coming Soon

You Asked, We Listened: Redesigned Events Page Coming Soon We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. Providers suggested that we display the [...]

March 2024

In This Issue National Government Services Articles for Part A and Part B Providers Common Working File (CWF) Host Dark Days for April 2024 Release Health Benefits of Quitting Smoking 2024 Gapfill Request Correct Coding of Molecular [...]

CMS Rural Health Resources

CMS Rural Health Clinics Center

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport CMS implemented the prior authorization program for RSNAT to reduce expenditures while maintaining and/or improving quality of care. This program applies to [...]

Appeals

Appeals State MAC Appeals Address Qualified Independent Contractor Address CT, MA, ME, NH, NY, RI, VT National Government Services, Inc. Appeals Department P.O. Box 7111 Indianapolis, IN 46207-7111 [...]

Claim Status <2>

table, td, th table { border-collapse: collapse; width: 50%; } Claim Status <2> If you are part of a group, remember to use the group NPI, PTAN and TIN for authentication purposes. When Claim Status is selected, the IVR will [...]

Investigational Device Exemption Requests ‒ Renewals and Modifications

Investigational Device Exemption Requests ‒ Renewals and Modifications Effective for Category A and B IDE studies approved by the FDA on or after 1/1/2015, interested parties (i.e. study sponsors) seeking Medicare coverage must submit a [...]

NGSMedicare.com Scheduled Maintenance: 3/9/2024-3/10/2024

NGSMedicare.com Scheduled Maintenance Due to scheduled maintenance, NGSMedicare.com will be inaccessible beginning Saturday, 3/9/2024 through Sunday, 3/10/2024. We apologize for any inconvenience this may cause. Posted 3/7/2024

MLN Connects® Newsletter: March 7, 2024

MLN Connects® Newsletter: March 7, 2024 News HHS Statement Regarding the Cyberattack on Change Healthcare Final Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Drug Costs Current Status of Blood [...]

You Asked, We Listened, We Delivered: Redesigned Events Page Live

You Asked, We Listened, We Delivered: Redesigned Events Page Live We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. Providers suggested that we display [...]

Advance and Accelerated Payment Program Available for Providers Impacted by the Change Healthcare/Optum Payment Disruption

Advance and Accelerated Payment Program Available for Providers Impacted by the Change Healthcare/Optum Payment Disruption Part A and Part B Providers experiencing cash flow problems related to Change Healthcare/Optum Payment Disruption [...]

The Change Healthcare/Optum Payment Disruption (CHOPD) CMS Fact Sheet Now Available

The Change Healthcare/Optum Payment Disruption (CHOPD) CMS Fact Sheet Now Available CMS issued the Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers Fact Sheet [...]

Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated and Advance Payments for Part A Providers and Part B Suppliers

Proper Medicare Part B Claim Submissions – Completion and Regulation for the CMS-1500 Paper Claim Form Due to the Change Healthcare Security Incident

Proper Medicare Part B Claim Submissions – Completion and Regulation for the CMS-1500 Paper Claim Form Due to the Change Healthcare Security Incident Health care professionals and suppliers play a vital role in protecting the integrity of the [...]

Reminder: Medicare Part A Claim Submissions Due to the Change Healthcare Security Incident

Reminder: Medicare Part A Claim Submissions Due to the Change Healthcare Security Incident Medicare Part A providers can use the FISS DDE for Part A claim entry. This option is free, and the provider may already use FISS DDE. Note: FISS DDE [...]

MLN Connects® Newsletter: March 14, 2024

MLN Connects® Newsletter: March 14, 2024 News CMS Roundup (Mar 8, 2024) Marriage and Family Therapists & Mental Health Counselors: Updated Enrollment FAQs Skilled Nursing Facilities: Billing Medicare for Respiratory Vaccines [...]

Nonphysician Practitioners-Reducing Costly Appeals; Increase Provider Revenue

Nonphysician Practitioners-Reducing Costly Appeals; Increase Provider Revenue National Government Services is committed to reducing the provider burden associated with Medicare claim denials and appeals. A significant segment of denials and [...]

Ambulance Physician Certification Statement Guidelines

Ambulance Physician Certification Statement Guidelines Certification Type Certification Required? Yes/No Who May Sign the Certification Timeframe Other Information /Resources Nonemergency, scheduled, [...]