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Posting Date: 11/15/2021
National Coverage Determination
National Coverage Determination NCDs are policies developed by CMS that indicates whether and under what circumstances certain services are covered under the Medicare Program. NCDs are the same for all contractors across the country. [...]
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Posting Date: 11/15/2021
National ICD-10-CM-PCS: The Next Generation of Coding
National ICD-10-CM-PCS: The Next Generation of Coding The ICD-10-CM-PCS classification system provides significant improvements through greater detailed information and the ability to expand to capture additional advancements in clinical [...]
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Posting Date: 11/15/2021
National Provider Calls and Events
National Provider Calls and Events MLN Connects® National Provider Calls (MLN Connects® Calls) are educational conference calls held by CMS for the Medicare provider and supplier community to educate and inform participants about new policies [...]
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Posting Date: 11/19/2021
National Provider Identifier
National Provider Identifier A National Provider Identifier is a unique 10-digit identification number issued to health care providers in the United States by the CMS. The NPI has replaced the UPIN as the required identifier for Medicare [...]
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Posting Date: 11/15/2021
National Provider Identifier Registry
National Provider Identifier Registry The NPI Registry is free and enables providers to search provider National Plan & Provider Enumeration System information. All information produced by the NPI Registry is provided in accordance with [...]
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Posting Date: 11/15/2021
National Uniform Claim Committee
National Uniform Claim Committee The NUCC is a voluntary organization that replaced the Uniform Claim Form Task Force in 1995. The committee was created to develop a standardized data set for use by the noninstitutional health care [...]
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Posting Date: 11/15/2021
Open Door Forums
Open Door Forums CMS conducts ODFs. The ODF addresses the concerns and issues of providers. Providers may participate via conference call and have the opportunity to express concerns and ask questions. For more information, including signing [...]
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Posting Date: 11/15/2021
P.O. Box Mailing Addresses
P.O. Box Mailing Addresses For the P.O. Box mailing addresses, please visit the Contact Us page on our website. Reviewed 10/21/2024
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Posting Date: 11/15/2021
Patient Protection and Affordable Care Act of 2010
Patient Protection and Affordable Care Act of 2010 For information related to the HIPAA Privacy and Security Rules, visit the Office for Civil Rights website. The Privacy and Security Rules are available for download, and you will find [...]
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Posting Date: 11/16/2021
Physician Quality Payment Program
Physician Quality Payment Program The MACRA ended the SGR formula for clinician payment under the MPFS and established a quality payment incentive program, the QPP. This program provides clinicians with two ways to participate: through [...]
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Posting Date: 11/16/2021
Provider Contact Center
Provider Contact Center For information about the Provider Contact Center, please visit the Contact Us page on our website. Reviewed 10/21/2024
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Posting Date: 11/16/2021
Provider Enrollment
Provider Enrollment The Provider Enrollment Customer Service Department has direct telephone lines available for provider enrollment inquiries. Toll-Free Provider Enrollment Numbers Please use the following toll-free provider enrollment [...]
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Posting Date: 11/16/2021
Reconsideration (Second Level of Appeal)
Reconsideration (Second Level of Appeal) A written reconsideration request must be filed with a QIC within 180 days of receipt of the redetermination. When providers receive an unfavorable redetermination, providers shall follow the [...]
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Posting Date: 11/16/2021
Recovery Audit Program
Recovery Audit Program The Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare [...]
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Posting Date: 11/16/2021
Redetermination (First Level of Appeal)
Redetermination (First Level of Appeal) A redetermination is an examination of a claim by National Government Services personnel who are different from the personnel who made the initial claim determination. The appellant (the provider filing [...]
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Posting Date: 11/16/2021
U.S. Government Printing Office
U.S. Government Printing Office The GPO is responsible for the production and distribution of information products and services including the official publications of Congress, the White House and other federal agencies in digital and print [...]
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Posting Date: 11/16/2021
Washington Publishing Company
Washington Publishing Company Washington Publishing Company, Inc. is a private company categorized under the commercial Printing and Newspaper Publishing Combined company that is an established health care IT and consulting company. WPC [...]
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Posting Date: 09/07/2021
CMS-1500 Claim Form Completion Instructions
CMS-1500 Claim Form Completion Instructions Table of Contents General Information Claim Filing Instructions for Paper and Electronic Submission Regulations on Charging for Claim Form Completion Optical Character Recognition System [...]
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