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Posting Date: 06/20/2024
Dental Claim Cross Over
Dental Claim Cross Over Medicare contractors coordinate with the MSP Contractor, GHI, to automatically cross over claim payment information for their policyholders as a courtesy. An eligibility file furnished by the supplemental insurer is [...]
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Posting Date: 11/03/2021
Three Ways to Protect Your Medicare Enrollment Information
Three Ways to Protect Your Medicare Enrollment Information Protect your enrollment information from Medicare fraud with these three steps: Keep your Medicare Provider Enrollment, Chain, and Ownership System (PECOS) user ID and password [...]
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Posting Date: 11/03/2021
Help Prevent Bank Account Fraud
Help Prevent Bank Account Fraud The provider should be aware of the following to help prevent bank account fraud if no authorized individual from your entity submits a change to enrollment. Contact your MAC immediately if: remittances [...]
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Posting Date: 07/18/2024
“Payer Only” Codes Submitted on Part A Medicare Claims
“Payer Only” Codes Submitted on Part A Medicare Claims This article is to inform Part A providers of an editing change impacting claims submitted with “payer only” codes. As of 7/3/2024, new edits cause claims to RTP when a “payer only” [...]
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Posting Date: 05/11/2022
Provider Enrollment Appeals Process
Provider Enrollment Appeals Process Table of Contents Provider Enrollment Appeals Process Corrective Action Plans Requirements for CAP Submission Reconsiderations Requirements for Reconsideration Request Submission Related Content [...]
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Rebuttal for Deactivation of Medicare Billing Privileges
Rebuttal for Deactivation of Medicare Billing Privileges Pursuant to 42 CFR, Section 424.545(b), a provider or supplier whose Medicare billing privileges have been deactivated may file a rebuttal in accordance with 42 CFR, Section 405.374. A [...]
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Posting Date: 02/09/2022
Rebuttal for Deactivation of Medicare Billing Privileges
Rebuttal for Deactivation of Medicare Billing Privileges Pursuant to 42 CFR, Section 424.545(b), a provider or supplier whose Medicare billing privileges have been deactivated may file a rebuttal in accordance with 42 CFR, Section 405.374. A [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 HH+H Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Services - Medical Necessity ICD-10 Z47-Z47.89 N/A 55H3V– The documentation did [...]
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