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Posting Date: 02/04/2022
Best Practices for a Successful Targeted Probe and Educate Review
Best Practices for a Successful Targeted Probe and Educate Review Table of Contents Getting Started With TPE Notification Letter During the Review Process Post-Probe/Review Results Letter Prepare for Post-Probe Education [Return to [...]
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Posting Date: 05/17/2023
Botulinum Toxin Best Practices
Botulinum Toxin Best Practices Botulinum toxins are potent neuromuscular blocking agents that are useful in treating various focal muscle spastic disorders and excessive muscle contractions, such as dystonias, spasms and twitches. They produce [...]
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Posting Date: 06/18/2024
B_How to Proactively Address Denials
How to Proactively Address Denials How to Proactively Address Denials Want to improve the Payment Error Rate for the next round of review? Be sure to learn about and understand claim denials before the end of round education with the Case [...]
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Posting Date: 03/20/2020
Provider Enrollment
Provider Enrollment The National Government Services Provider Customer Care Department has direct telephone lines available for provider enrollment inquiries. Who should I call for technical issues regarding PECOS, EUS Helpdesk or MAC? CMS [...]
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Posting Date: 05/13/2020
Provider Enrollment
Provider Enrollment The National Government Services Provider Customer Care Department has direct telephone lines available for provider enrollment inquiries. Who should I call for technical issues regarding PECOS, EUS Helpdesk or MAC? CMS [...]
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Posting Date: 03/08/2019
Opt Out and Private Contracting
Opt Out and Private Contracting Opt out does not require a physician or practitioner to initially enroll with Medicare or complete a CMS-855I application. Opting out of Medicare allows a physician or practitioner to render services to [...]
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Posting Date: 03/08/2019
Renewal to the Medicare Opt-Out Law for Physicians and Practitioners
Renewal to the Medicare Opt-Out Law for Physicians and Practitioners Prior to enactment of the MARCA of 2015, physician or practitioner opt-out affidavits were only effective for two years. As a result of changes made by MACRA, valid opt-out [...]
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Posting Date: 03/08/2019
Opt-Out Physician or Practitioner Providing Emergency or Urgent Care
Opt-Out Physician or Practitioner Providing Emergency or Urgent Care In an emergency or urgent situation, a physician or practitioner who opts out may treat a Medicare beneficiary with whom they do not have a private contract. In this [...]
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Posting Date: 08/27/2021
Providers Not Eligible to Opt Out and Enter Into Private Contracts
Providers Not Eligible to Opt Out and Enter Into Private Contracts Providers Who May Not Opt Out of the Medicare Program Chiropractors Opt-out law does not define ‘physician’ to include chiropractors; therefore, they may not opt out of [...]
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Posting Date: 03/08/2019
Instructions to File
Instructions to File The requirements to opting out of Medicare are included on the forms. First, at least one private contracting agreement form must be signed between the physician or practitioner and a beneficiary. Second, the physician [...]
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