55H1L

Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]

55H1R

Avoiding/Correcting This Error Review coverage and billing guidelines for the NOE to ensure that your NOEs are accurately billed. Related Content CMS IOM Publication 100-02, Medicare Benefit Policy Manual, Chapter 9, Section [...]

Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics available are: ASCA Appeals CAR T-cell [...]

Overpayment: How Should I Respond?

Table of Contents Overpayment: How Should I Respond? What Action Should I Take? Complete a Voluntary Refund Where Should I Send my Forms and Payments? [Return to Top] Overpayment: How Should I Respond? An overpayment may be [...]

Request an Immediate Recoupment

National Government Services has implemented a standardized “immediate recoupment” process that gives you the option to avoid interest from accruing on claims overpayments when the debt is recouped in full prior to or by the 30th day from the [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible, the refund to Medicare should be [...]

Set Up an Extended Repayment Schedule

If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]

Payment Withholding Information

Payment Withholding Information What Is a Payment Withholding? Why Are Payments Withheld? Who Can I Contact for Further Assistance? What About Cost Report Interim and Final Settlement Withholdings? What Is a Payment Withholding? An [...]

MSP Post-Pay Adjustments

If you have received an overpayment because Medicare paid as the primary insurer and another insurance carrier should be the primary payer, follow the instructions on the Part A voluntary refund form. A separate refund form is needed for [...]

Refunds Due to Beneficiaries by Providers

Refunds Due to Beneficiaries by Providers In some situations, providers are responsible for refunding monies to beneficiaries that have paid for services providers have determined to be noncovered and nonpayable by Medicare. When an ABN has [...]

Credit Balance Reporting

Table of Contents What is a Credit Balance? What Should I Do When I Have a Credit Balance? Additional Tips for a Successful Credit Balance Report Submission [Return to Top] What is a Credit Balance? Generally, when a provider [...]

Part A Fundamentals of Medicare Online Guide

Part A Fundamentals of Medicare Online Guide Attention Part A Providers and Support Staff:  National Government Services produces the Fundamentals of Medicare online guide to help build understanding of the Original Medicare [...]

Medicare Participating Physicians Directory

Medicare Participating Physicians Directory The 2025 MEDPARD is now available. It includes all Part B providers in Jurisdiction 6 and Jurisdiction K who have agreed to accept assignment on all Medicare-covered services. The updated list [...]

New Medicare Part B Redetermination Notice Initiative

New Medicare Part B Redetermination Notice Initiative  National Government Services is excited to announce a new initiative for providers who submit Medicare Part B appeals using our portal, NGSConnex.  Starting 3/3/2025, NGS [...]

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits 

Take Advantage of Tobacco Counseling When Performing Medicare Wellness Visits Medicare providers have a valuable opportunity to optimize revenue and improve patient outcomes through Medicare's Annual Wellness Visits. These visits help identify [...]

EDI Gateway Outage

The National Government Services EDI gateway was unavailable for all submitters. 

Set Up an Extended Repayment Schedule

Forms you’ll need J6 Applying for an Extended Repayment Schedule JK Applying for an Extended Repayment Schedule If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted [...]

J6 Part B Applying for an Extended Repayment Schedule

Diabetes Screening

Preventive Services Guide Diabetes Screening Table of Contents Diabetes Screening Coverage Criteria and Frequency Limits HCPCS/CPT Coding Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Common Claim [...]

KX Modifier Threshold

KX Modifier Threshold The Bipartisan Budget Act of 2018 repealed application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that [...]