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Posting Date: 03/02/2020
Quality Innovation Networks - Quality Improvement Organizations Quality Initiatives
Quality Innovation Networks - Quality Improvement Organizations Quality Initiatives CMS leads a national health care quality improvement network of Quality Innovation Networks – Quality Improvement Organizations (QIN-QIOs). Locally, an [...]
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Posting Date: 08/28/2020
Providers' Obligation to Report and Refund Medicare Overpayments with Appropriate Forms
Providers' Obligation to Report and Refund Medicare Overpayments with Appropriate Forms Healthcare providers have an obligation to report and refund federal program overpayments and continue to do so, but National Government Services would [...]
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Posting Date: 10/07/2020
Provider Enrollment Reconsideration Request Reminders
Provider Enrollment Reconsideration Request Reminders National Government Services has been receiving reconsiderations of provider enrollment credentialing requests that do not fall into the appropriate criteria for reconsiderations due to the [...]
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Posting Date: 06/09/2020
Proper Billing for Telehealth Services Claims
Proper Billing for Telehealth Services Claims We have received a high volume of paper CMS-1500 claim forms for telehealth services with dates of service during the PHE that we have to reject because they are improperly coded with two different [...]
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Posting Date: 07/23/2020
Prior Authorization Request Reminders
Prior Authorization Request Reminders Effective for dates of service on or after 7/1/2020, a PAR is required for certain OPD services. For additional information on the Medicare Prior Authorization Program go to our website > log in to any [...]
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Posting Date: 06/04/2020
Prior Authorization Program Becomes Effective for Dates of Service on/after 7/1/2020
Prior Authorization Program Becomes Effective for Dates of Service on/after 7/1/2020 The CMS is implementing a prior authorization program for certain hospital outpatient department services effective for dates of service on or after 7/1/2020. [...]
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Posting Date: 01/16/2020
Reminder: Providers on Automatic Immediate Recoupments
Reminder: Providers on Automatic Immediate Recoupments If you are set up for automatic recoupments, please refrain from submitting checks and overpayment forms. Submitting receipts run the risk of money being offset and your check being [...]
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Posting Date: 12/17/2020
Physicians/Practitioners Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients
Physicians/Practitioners: Medical Records Play a Vital Role in Ordering and Providing DMEPOS to Your Patients For any DMEPOS item to be covered by Medicare, the patient’s medical record must contain sufficient information about the patient’s [...]
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Posting Date: 06/09/2020
Update on Claims for COVID-19 Testing
Update on Claims for COVID-19 Testing As per CMS PHE guidelines, National Government Services is modifying internal claim editing to permit the following COVID-19-related procedure codes to process as potentially payable without ICD-10 [...]
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Posting Date: 12/14/2020
The CY 2021 MPFS Is Now Available
The CY 2021 MPFS Is Now Available The CY 2021 MPFS is now available. You can view the new fees using the Fee Schedule Lookup tool page on our website. Posted 12/14/2020
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