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Posting Date: 04/22/2024
Top Claim Errors Have Been Reviewed and Updated
Top Claim Errors Have Been Reviewed and Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors under Resources > Claims and Appeals to learn what you can do to avoid claim [...]
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Posting Date: 04/23/2024
Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex
Table of Contents Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex What are the benefits? [Return to Top] Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex National Government [...]
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Posting Date: 04/24/2024
Home Office Cost Statements
A home office of a chain organization is a related organization to its participating providers. Home offices usually furnish central management and administrative services, e.g., centralized accounting, purchasing, personnel services, [...]
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Posting Date: 04/25/2024
MLN Connects® Newsletter: April 25, 2024 (UPDATE)
MLN Connects® Newsletter: April 25, 2024 (UPDATE) Editor's Note: CMS updated a message because we delayed the effective date that physicians who certify hospice services must enroll in or opt-out of Medicare until 6/3/2024. You may have to [...]
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Posting Date: 04/29/2024
LCD and Article Updates for April/May 2024
LCD and Article Updates for April/May 2024 Billing and Coding Articles Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin (A59311) [...]
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Posting Date: 04/29/2024
Billing for Drug Wastage: JW and JZ Modifier
Billing for Drug Wastage: JW and JZ Modifier Properly billing for drug wastage and associated modifiers helps to prevent claims processing errors and denials while ensuring you receive correct reimbursement. Providers and suppliers are to [...]
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Posting Date: 04/29/2024
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024)
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024) The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 4/25/2024 through [...]
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Posting Date: 04/29/2024
What Are the Recovery Auditors' Responsibilities_Part A-B-FQHC-HHH
What Are the Recovery Auditors' Responsibilities? What Are the Recovery Auditors' Responsibilities? Recovery Auditors review claims on a postpayment basis using the same Medicare policies as MACs: NCDs LCDs and CMS manuals/regulations To ensure [...]
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Posting Date: 04/29/2024
How Will I Know When a Payment Determination Has Been Issued_Part A-B-FQHC-HHH
How Will I Know When a Payment Determination Has Been Issued? How Will I Know When a Payment Determination Has Been Issued? When a Recovery Auditor finds that improper payments have been made, they will submit claim adjustments to your MAC. The [...]
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Posting Date: 04/29/2024
ALOB_What Are My Options When I Receive the Recovery Auditor Demand Letter
What Are My Options When I Receive the Recovery Auditor Demand Letter? What Are My Options When I Receive the Recovery Auditor Demand Letter? If you agree with the Recovery Auditor’s determination you can: repay the overpayment amount by check; [...]
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