Medicare Overpayments Are Not Redeterminations

Medicare Overpayments Are Not Redeterminations Our records indicate some providers are incorrectly submitting redetermination request forms for MSP overpayment issues. Please use this notification as educational instruction from National [...]

MLN Connects® Newsletter: October 26, 2023

MLN Connects® Newsletter: October 26, 2023 News Help CMS Improve Provider Resources — Respond by November 9 CMS Roundup (Oct 20, 2023) Nursing Facility Evaluation and Management Visits: Comparative Billing Report in October Claims, [...]

Part B Top Claim Errors Are Updated

Part B Top Claim Errors Are Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to avoid claim processing delays. We’ve listed the error reason code, a [...]

Prior Authorization Outpatient Department Exemption Additional Documentation Requests

Prior Authorization Outpatient Department Exemption Additional Documentation Requests National Government Services Prior Authorization initiated the process of issuing ADRs to exempt providers. Please monitor your facility’s ADR location [...]

Coming Soon ‒ The CY 2024 Medicare Physician Fee Schedule

Coming Soon - The CY 2024 Medicare Physician Fee Schedule The CY 2024 MPFS will soon be available on the Fee Schedule Lookup tool located on NGSMedicare.com, after the CY 2024 physician fee schedule regulation is put on display. Once the Fee [...]

Electronic Cost Report Exhibit Templates

Who May File an Appeal

Who May File an Appeal? Table of Contents Who May File an Appeal? Appointment of Representative When Is an Appointment Not Necessary? Who May Be a Representative How to Make and Revoke an Appointment When Is an Appointment Not [...]

Reopenings for Minor Errors and Omissions

Reopenings for Minor Errors and Omissions Table of Contents Reopenings for Minor Errors and Omissions What is a Clerical Error? Clerical Error and Omission Reopening Request Request a Reopening- NGSConnex Request a Reopening- In Writing [...]

Review Bad Debt Listing

Table of Contents Review Bad Debt Listing Identifying Fee Schedule Services Fee Schedules Included in Bad Debt Policy Related Content [Return to Top] Review Bad Debt Listing Bad debts are unrecovered costs due to uncollectible [...]

Hospice Cap

Hospice Cap Table of Contents The Inpatient Day Limitation Aggregate Cap Calculation Beneficiary Count Proportional Method (applies to most hospices) Streamlined Method  [Return to Top] The Inpatient Day Limitation [...]