Accessing Eligibility for MDPP in NGSConnex

5010 top page

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for Durable Medical Equipment

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the edit code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code information [...]

ASP Drug Form Description

ASP Drug Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulance Form Description

Ambulance Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulatory Form Description

Ambulatory Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Payment Withholding Information

Payment Withholding Information What Is a Payment Withholding? Why Are Payments Withheld? Who Can I Contact for Further Assistance? What About Cost Report Interim and Final Settlement Withholdings? What Is a Payment Withholding? An [...]

Medicare Compliance

AppealsDecisionTreePartATop

Appeals Decision Tree

Appeals Decision Tree Part B Bottom

Appeals Decision Tree Part B Top

Appeals Decision Tree

AppealsDecisionTreePartABottom

Behavioral Health Integration Services for Primary Care Providers

Behavioral Health Integration Services for Primary Care Providers Medicare BHI service for your patients that do not require the use of a behavioral health care team. Primary care physicians who are treating Medicare patients with [...]

CMS Helpful Links

CMS Helpful Links

CMS Helpful Links

DME MAC Jurisdiction A

DME MAC Jurisdiction B

DME MAC Jurisdiction C

DME MAC Jurisdiction D

NPPES

Remittance Advice Codes

USA.gov

American Medical Association

Prepare and Submit an MSP Conditional Claim 

Maximum Payment Limits for Rural Health Centers

Coverage of Rural Air Ambulance Services

Federally Qualified Health Center Payment Limits

New York State Ambulance Services in Rural Areas

Health Professional Shortage Area

FISS/DDE Provider Online Guide: Chapter IV - ZIP Code File (19)

Submit Supporting Documentation

Ambulance Rural ZIP Code Search

Fundamentals of Medicare: Skilled Nursing Facility Inpatient Care

Get Help Submitting an Appeal Hard Copy

Get Help Submitting an Appeal Hard Copy All levels of appeals may be submitted by mail. The only types of appeals submitted to National Government Services are reopening and redetermination requests. For information on other types of appeals, [...]

Get Help Submitting an Appeal Hard Copy

Get Help Submitting an Appeal Hard Copy All levels of appeals may be submitted by mail. The only types of appeals submitted to National Government Services are reopening and redetermination requests. For information on other types of appeals, [...]

Request a Redetermination

Request a Redetermination The first level of appeal is the redetermination and is carried out by the MAC. Time limit to initiate = 120 days from date of receipt of the initial determination notice Time limit to complete the [...]

PC-ACE Roster Billing Guide

PC-ACE Roster Billing Guide Roster billing is a feature of PC-ACE that allows the provider to create many nearly identical claims for flu and pneumonia vaccines quickly. PC-ACE is now equipped for COVID-19 vaccine roster billing as well. [...]

Appeals Decision Tree

Appeals Decision Tree

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible the refund to Medicare should be [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. All checks are made payable to National Government [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible, the refund to Medicare should be [...]

5010 Top Page for Part B

EDI Front End Rejection Code Lookup Tool To view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

Person(s) with Medicare

Person(s) with Medicare  Home Contacts & Resources Coverage & Billing Education Medicare Plans News

Cardiac Positron Emission Tomography Pricing Change

Cardiac Positron Emission Tomography Pricing Change Effective 1/1/2020 there nine CPT codes that describe PET as noted in the lists below. Of the nine listed codes, six (group 1) are new for 2020 and are contractor priced codes for the TC and [...]

National Correct Coding Initiative

Remittance Advice

RuralServ

Telehealth

How to File an Appeal with Original Medicare

State Health Insurance Assistance Program

Verify and Manage Signatures