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  • Posting Date: 01/18/2022
    Appeals Process

    Section 3: Fraud and Abuse Appeals Process Table of Contents Appeals Process The Five Levels of Appeal Appeals Request Process First Level—Redetermination Second Level—Reconsideration Third Level—Administrative Law Judge [...]

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  • Posting Date: 04/28/2015
    Comprehensive Error Rate Testing Process

    Section 3: Fraud and Abuse Comprehensive Error Rate Testing Process Table of Contents Comprehensive Error Rate Testing Process What is CERT? Who Performs CERT? How Does It Work? CERT Information Available from CMS [Return to Top] [...]

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  • Posting Date: 04/28/2015
    Registration of the Medicare Patient

    Section 4: Getting Ready to Bill Medicare Registration of the Medicare Patient When a Medicare beneficiary receives hospital or other medical services, he/she is generally registered at the facility. It is possible that the patient may [...]

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  • Posting Date: 11/07/2024
    MLN Connects® Newsletter: November 7, 2024

    MLN Connects® Newsletter: November 7, 2024 Final Rules Physician Fee Schedule CY 2025 Final Rule Hospital Outpatient Prospective Payment System & Ambulatory Surgical Center Payment System CY 2025 Final Rule ESRD Prospective Payment [...]

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  • Posting Date: 11/07/2024
    Introduction to Medicare Part II

    Are you new to the Medicare Program? Attend our Introduction to Medicare Part I and II Webinars! Each session will be 1 hour with 15 minutes of Q&A. Part II will focus on: Local Coverage Determinations, Claim Filing Guidelines, Preventive [...]

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  • Posting Date: 11/07/2024
    Medicare Part B Drugs and Biologicals

    During this webinar, we’ll provide and in-depth overview of Medicare Part B drug and biological coverage guidelines, pricing, reimbursement and proper billing criteria. We’ll also share educational resources to help ensure proper claim submission.

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  • Posting Date: 11/07/2024
    Provider Enrollment: Completing the CMS-855A Paper Application

    During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.

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  • Posting Date: 04/13/2023
    Top Tobacco Counseling Claim Errors

    Top Tobacco Counseling Claim Errors Reason Code(s) Description Avoiding/Correcting This Error OA-18 A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a [...]

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