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Posting Date: 08/07/2024
Unnecessary Adjustments for Part B Claims
Unnecessary Adjustments for Part B Claims A recent transition process at the Medicare Part B system maintainer has resulted in unnecessary and inappropriate Part B claim adjustments, impacting all MACs nationwide. This issue started to occur [...]
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Posting Date: 08/23/2023
Incident to Quick Reference Chart
Incident to Quick Reference Chart Location PT Status Scenario Who Bills Comments Office New patient NPP sees patient - MD not present in office suite NPP bills for the service under the NPP NPI NPP [...]
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Posting Date: 08/05/2024
ASCA Requirements for Paper Claim Submissions
Table of Contents ASCA Requirements for Paper Claim Submissions Submitting Electronic Claims Submitting Paper Claims ASCA Exception Criteria Related Content [Return to Top] ASCA Requirements for Paper Claim Submissions [...]
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Posting Date: 11/13/2020
“Incident to” Services
“Incident to” Services This article has been specially designed for our providers who perform services “Incident to” the services of a physician/NPP. Table of Contents The “Incident to” Provision of Medicare Your Office Hospital or [...]
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Posting Date: 10/15/2021
Home Health Referrals
Home Health Referrals Table of Contents Home Health Referrals Order for Home Health Services Documentation to Support Homebound Status Documentation to Support the Need for Skilled Services Documentation Regarding the Face-to-Face [...]
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Posting Date: 08/08/2024
Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013
Supplemental Security Income Ratio Realignment for Cost Reporting Periods Starting Before 10/1/2013 On 6/9/2023, in response to the Supreme Court’s ruling in Azar v. Allina Health Services, 139 S. Ct. 1804 (2019), the CMS issued a final rule [...]
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Posting Date: 02/02/2021
About Appeals
About Appeals Table of Contents About Appeals Reopening vs. Redetermination Reopening Redetermination [Return to Top] About Appeals Providers and beneficiaries have the right to appeal claim determinations made by National [...]
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Posting Date: 01/27/2015
Home Health Forms – Which is Required?
Home Health Forms – Which is Required? The Advance Beneficiary Notice/Home Health Change of Care Notice/Notice of Medicare Noncoverage Scenario ABN HHHCN NOMNC Patient met goals under the POC and is being [...]
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