EDI: What is an Approved Entity?

EDI: What is a Network Service Vendor (NSV)?

EDI: What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance?

EDI: What provider address should I include on the EDI enrollment forms?

EDI: When is a provider authorization form required?

EDI: Will you reject claims with a P.O. Box in the billing provider address?

EDI: Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description?

EDI: Will you reject claims where the group number and policy number are the same values?

LCD NCD: How do I find out if an LCD or medical coverage policy has changed in my jurisdiction?

LCD NCD: What are Medical Policy Articles?

LCD NCD: Does NGS offer any other LCD resources?

LCD NCD: How do I search for an LCD if I do not know the LCD number?

LCD NCD: How can I view and comment on proposed LCDs?

LCD NCD: Can I request a change be made to a current LCD?

LCD NCD: How do I find LCDs?

Ambulance Duplicate Claim Denials

Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]

Ambulance Transports Included in SNF Consolidated Billing

Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]

Top JK Part B Claim Errors are Available

Top JK Part B Claim Errors are Available We conduct a comprehensive data analysis on a quarterly basis to update and disseminate the latest insights on the most common claim errors. This initiative provides:  Claim Error Reason Code [...]

CO-16

Avoiding/Correcting This Error The MBI is necessary for all claims submitted to MAC. Claims without a correct MBI are rejected, requiring providers to verify and resubmit them. To avoid this, use the Eligibility Lookup in NGSConnex before [...]

CO-16

Avoiding/Correcting This Error The billing provider's information on the claim is missing or invalid. To avoid this error, ensure the following details are accurate and included: the billing provider's NPI, name, address, ZIP code, and phone [...]