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Posting Date: 10/07/2022
Participation Program
Medicare Part B 101 Manual Participation Program Table of Contents Eligibility Participation Enrollment Period/Participating Status Changes Participation Program Participating Provider Nonparticipating Provider When [...]
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Posting Date: 10/07/2022
Ordering and Referring Claims Information
Medicare Part B 101 Manual Ordering and Referring Claims Information Table of Contents Ordering and Referring Claims Information How to Identify the Ordering or Referring Provider on a Claim Ordering and Referring Eligible Provider [...]
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Posting Date: 03/04/2021
Refunds and Overpayments
Medicare Part B 101 Manual Refunds and Overpayments Table of Contents Medicare Contractor Initiated Demand Letters Providers Not on Automatic Recoupments Jurisdiction K (CT, MA, ME, NH, NY, RI , VT) Jurisdiction 6 (IL, MN, WI) [...]
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Posting Date: 10/07/2022
Return/Reject
Medicare Part B 101 Manual Return/Reject While it's easy to group processed claims as either approved or denied, there are differences in the way claims are returned unpaid by Medicare. Only claims that are filed with complete and correct [...]
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Posting Date: 10/07/2022
Health Professional Shortage Area
Medicare Part B 101 Manual Health Professional Shortage Area What is a HPSA? What is the HPSA Incentive Bonus? Who is Eligible for the Incentive Bonus? How is the Bonus Billed? What Else You Should Know To Learn More [Return to [...]
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Posting Date: 10/07/2022
Assignment of Benefits
Medicare Part B 101 Manual Assignment of Benefits Table of Contents Assignment of Benefits Mandatory Assignment Collecting from Medicare Patients on Assigned Claims Related Content [Return to Top] Assignment of Benefits An [...]
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Posting Date: 10/12/2021
Advance Beneficiary Notice of Noncoverage for Not Reasonable and Necessary Denials
Medicare Part B 101 Manual Advance Beneficiary Notice of Noncoverage for Not Reasonable and Necessary Denials Table of Contents Limited Coverage Medical Necessity Expectations ICD-10-CM Coding Reasons for Noncoverage Beneficiary [...]
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Posting Date: 10/18/2024
Set Up a Beneficiary's Medicare Secondary Payer Record
Table of Contents Background: Set Up a Beneficiary’s Medicare Secondary Payer Record Step 1: Provider Receives New MSP Information for a Beneficiary Step 2: Check for a Matching Medicare Secondary Payer Record for the Beneficiary in the [...]
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Posting Date: 08/04/2022
Modifier 90 Reference to Outside Laboratory
Modifier 90: Reference to Outside Laboratory Modifier 90 is to be used when the billing laboratory refers a specimen to another laboratory for testing. In these cases, the billing laboratory is titled the “referring laboratory” while the [...]
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