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Posting Date: 06/09/2021
Expedited Requests
Expedited Requests The requester may submit for an expedited review of the PAR if it is determined that a delay could seriously jeopardize the beneficiary’s life, health, or ability to regain maximum function. If the medical documentation does [...]
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Posting Date: 06/09/2021
About Hospital OPD PA Model
About Hospital OPD PA Model Table of Contents About Hospital OPD PA Model General Information Related Content [Return to Top] About the Hospital OPD PA Model CMS implemented a PA program for certain hospital OPD services for DOS on [...]
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Posting Date: 06/14/2022
Documentation Information
Documentation Information It is recommended that PARs are submitted at least seven calendar days prior to the expected date of service to allow National Government Services the full standard timeframe to receive and review requests. For [...]
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Posting Date: 02/26/2022
Account Suspensions
Account Suspensions Table of Contents Account Suspensions Unsuspend Your Account Invalid Login Attempts [Return to Top] Account Suspensions If an NGSConnex account has not been used within the last 30 days, the account will be [...]
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Posting Date: 01/25/2024
Caregiver Training Services
Caregiver Training Services Effective 1/1/2024, payment will be made when practitioners train caregivers to support patients with certain diseases or illnesses (e.g., dementia) in carrying out a treatment plan. A caregiver is defined as a [...]
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Posting Date: 03/19/2025
Safeguard Your Finances: Know Your Provider Enrollment Revalidation
Safeguard Your Finances: Know Your Provider Enrollment Revalidation Attention: Provider Enrollment and Credentialing Teams Ensure you revalidate before your deadline to prevent a "Stay of Enrollment" or claim rejections, which could result in [...]
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Posting Date: 03/24/2025
Medicare Diabetes Prevention Program 2025 Changes
Medicare Diabetes Prevention Program 2025 Changes The MDPP Expanded Model is intended to prevent Medicare beneficiaries with an indication of prediabetes from developing diabetes. Prevention of diabetes among this high-risk group of Medicare [...]
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Posting Date: 03/24/2025
Home Health Claims Returning to Provider RC 19963
HH claims are returning to provider in error with RC 19963. This impacts HH claims with NOA/processed dates in January 2022. NOAs are being purged after 24 months. Please keep in mind there are claims that edit correctly for this reason code. [...]
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Posting Date: 03/02/2021
NGS Office of Congressional Affairs Welcome Letter
Dear Members of Congress and Staff: As your work continues in the 119th Congress, National Government Services, Inc. maintains its dedicated role in serving your district/state as a Medicare contractor for Original Medicare. We are your [...]
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