MEDICAL REVIEW: Where can I get answers to billing questions?

MEDICAL REVIEW: Where can I find more details about the reasons my claims were denied?

MEDICAL REVIEW: What constitutes a valid signature?

MEDICAL REVIEW: What mailing address does NGS use to send Medical Review additional documentation requests (ADRs) to providers?

MEDICAL REVIEW: We are a large group and could potentially have many providers on TPE review. We have difficulty managing the process for each provider. Does NGS have any guidance for large groups?

MEDICAL REVIEW: The Medical Review Department did a post payment review of my Medicare claim and it was denied. How do I pay the money back to NGS Medicare?

MEDICAL REVIEW: My claim was denied “56900 Documentation not received”; however, I did send in documentation. What now?

MEDICAL REVIEW: My claim was reopened or adjusted by Medical Review. Does this impact the appeal window?

MEDICAL REVIEW: How do I sign up for the CMS and NGS Listserv messages?

MEDICAL REVIEW: I am under TPE review and my claims were denied, who can I speak to about this?

MEDICAL REVIEW: I’m appealing my claim but received a letter to recoup funds from the TPE denial. What do I do about these letters?

MEDICAL REVIEW: How do I change my address and which address exactly am I changing to ensure receipt of the MR letters and ADRs?

MEDICAL REVIEW: How do I respond to an ADR Not In List?

MEDICAL REVIEW: How do I request an appeal on a claim reviewed by the Medical Review Department?

MEDICAL REVIEW: How do I appeal a claim that MR reviewed but went to a T status or R status because of a CWF issue after MR processed?

MEDICAL REVIEW: How can I use NGSConnex to respond to Medical Review additional documentation requests?

Resources

Resources You Can Help Your Patients Quit Tobacco Use Smoking Cessation Tools and Resources Smokefree.gov Centers for Disease Control and Prevention: Tips from Former Smokers campaign Centers for Disease Control and Prevention: Office on [...]

COVID-19 Vaccine and Monoclonal Antibody

COVID-19 Vaccine and Monoclonal Antibody With the end of the PHE, as of 5/11/2023, this information no longer applies. We will keep the information available for PHE-related services that occurred prior to the expiration date that have not yet [...]

Prepare and Submit an MSP Claim

Table of Contents Step 1: Determine if an MSP Claim Must be Submitted to Medicare Step 2: Check Medicare’s Eligibility Files via NGSConnex to Determine if There's Other Insurance Primary to Medicare Step 3: Prepare the MSP (Partial-Payment [...]

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