About Us Part A Right Side

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About Us Part B Right Side

About Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right SideAbout Us Part B Right Side

Part B Right Content

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Part A Right Content

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Part B Right Content

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Part B Right Content

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Part A Right Content

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Part A Right Content

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Cardiac Part A

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Cardiac Part B

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JK Overpayment Recovery Unit Part B Carrier Voluntary Refund Form

J6 Part A Overpayment Recovery Unit Voluntary Refund Form

Medicare Opt-Out Affidavit

Medicare Private Contract Form

Provider Transaction Access Number Request Form

Jurisdiction K Medicare Part A MSP Overpayment Request Form

Low / No Utilization Cost Report Waiver

JK Part A Overpayment Recovery Unit Voluntary Refund Form

Medicare Part B PWK Fax/Mail/esMD Cover Sheet

Medicare Part B PWK Fax/Mail/esMD Cover Sheet

Level 3: Request for an Administrative Law Judge Hearing or Review of Dismissal (OMHA‐100)

J6 Part A Immediate Recoupment Request Form

Jurisdiction 6 Medicare Part A Overpayment Request Form

JK Part B Immediate Recoupment Request Form

Home Health Third Party Liability Demand Bill Redetermination Request Form

Medicare Home Health and Hospice PWK Fax/Mail Cover Sheet

Level 1: Part A Redetermination Request Form

J6 Overpayment Recovery Unit Part B Carrier Voluntary Refund Form

J6 Part B Immediate Recoupment Request Form

JK Part B Medicare Secondary Payer Overpayment Request Form

Cover Sheet for Electronically Submitted Medical Records

Level 2: Reconsideration Request Form (CMS-20033)

Investigational Device Exemption Requests

Medicare Part A PWK Fax/Mail Cover Sheet

Jurisdiction 6 Medicare Part A MSP Overpayment Request Form

Education Partnership Request Form

Jurisdiction K Medicare Part A Overpayment Request Form

JK Extended Repayment Plan Request Form

Interim Rate Review Documentation Request Form for TEFRA Hospital/Unit

Interim Rate Review Documentation Request Form for Critical Access Hospitals

Website Feedback Form

Website Feedback Form We value your feedback about our website. Please tell us about your experience and provide any suggestions for improvement. This form is for the submission of feedback regarding your recent website experience; it [...]

Browser Requirements

Browser Requirements For an optimal NGSMedicare.com experience, to access both the secure, self-service provider portal NGSConnex and the provider content website, you are required to use one of the supported browsers below. Microsoft [...]

Level 4: Review of Hearing Decision Form (DAB-101)

Vaccine Roster Form

Medicare Credit Balance Report Form and Instructions (CMS-838)

Medicare Credit Balance Report (CMS-838) Excel Spreadsheet

PC-ACE Download

PC-ACE DownloadTo ensure that PC-ACE and its documentation are being downloaded by National Government Services member providers and to help us determine our providers' utilization of PC-ACE software please provide the following information.For [...]

State License and Registrations for Individuals and Organizations

Enrollment Application Forms

Electronic Funds Transfer

Electronic Funds Transfer Form and Instructions

Enrollment Application Forms

NGSConnex: Initiating and Checking Status of Reconsiderations

Did you know that you can save time and money by requesting a reconsideration via NGSConnex? When you submit reconsideration requests electronically using NGSConnex, you no longer need to complete a form, copy documentation and waste time with [...]

Prepare and Submit a Cost Report