Billing Overlap/Dispute Resolution Process Effective 3/1/2023

Billing Overlap/Dispute Resolution Process Effective 3/1/2023 An overlapping situation may occur between hospitals for inpatient stays, home health agencies, outpatient services and hospice agencies. Overlapping situations may also occur due [...]

Hospice Claims Edit Issue RC W7048

National Government Services has noted an increase in hospice claims editing incorrectly for RC W7048 following the July 2023 system release. This is occurring for revenue codes 0250 (non-injectable prescription drugs), 0290 and/or 0294 [...]

Guidelines for Submitting Prior Authorization Certain Hospital Outpatient Department

General PAR Documentation Requesters must include the following data elements in all PARs to avoid potential delays in processing. Your MAC may request additional, optional elements for submission of the PAR. Initial Submission Documentation: [...]

Dispute Request for Assistance (RFA) Form

CMS Links

  Administrative Simplification Overview Ambulatory Surgical Centers (ASC) Center  Clinical Laboratory Improvement Amendments (CLIA)  Beneficiary Notices Initiative (BNI)  CMS.gov Email Updates CMS.gov Open [...]

Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident

Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident With many providers submitting paper claims due to the Change Healthcare security incident, it is important to submit your claims correctly. Failure to do [...]

MLN Connects® Newsletter: April 11, 2024

MLN Connects® Newsletter: April 11, 2024 Proposed Payment Rules CMS Proposes New Policies to Support Underserved Communities, Ease Drug Shortages, and Promote Patient Safety News CMS Roundup (Apr. 5, 2024) Medicare Shared Savings [...]

NGSConnex Medicare Part B Remittances

NGSConnex Medicare Part B Remittances We’ve added an enhancement that offers providers the option to view/print remittance advices in NGSConnex for up to 24 months from the date of search. You are required to complete the EDI enrollment to [...]