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 [...]

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 [...]

“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” [...]

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 [...]

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 [...]

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 [...]

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 [...]

837D Edit Spreadsheet

Requests for Additional Information

Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]

Approval Pending Regional Office Review

Approval Pending Regional Office Review For ASC and PXRS: When credentialing, you will receive an approval pending regional office review status in PECOS, if there is a change processed that requires a tie-in notice (Centers for Medicare [...]