Home Health Billing

Avoiding Reason Code 38200

CR 9189 Transmittal 602: Medical Review of Home Health Services

Contractor Advisory Committee

Assist National Government Services in the Development of Local Coverage Determinations Background CMS released Change Request 10901 and the companion MLN® Matters MM10901: Local Coverage Determinations (LCDs) article to expand the parameters [...]

Appeals/Reopenings

Medicare Part B 101 Manual Appeals/Reopenings Table of contents Reopenings for Minor Errors and Omissions Telephone Reopening Unit Appeals Time Limit for Filing Appointment of Representative Redeterminations Acceptable Signature [...]

CMS-1500 Claim Form

Medicare Part B 101 Manual CMS-1500 Claim Form Table of Contents General Information Claim Filing Instructions for Paper and Electronic Submission Regulations on Charging for Claim Form Completion OCR System Missing, Incomplete, [...]

Comprehensive Error Rate Testing

Medicare Part B 101 Manual Comprehensive Error Rate Testing Table of Contents Comprehensive Error Rate Testing What Is CERT? How Long Do Providers Have to Respond to a Request From the CERT Contractor? What Happens if the Provider [...]

Fraud and Abuse

Medicare Part B 101 Manual Fraud and Abuse Fraud and Abuse Unified Program Integrity Contractors Defining Fraud and Abuse Fraud Abuse Bribes, Kickbacks and Rebates Penalties Waiving Deductible and Coinsurance What You Can Do As a [...]

Medical Policy Development

Medicare Part B 101 Manual Medical Policy Development Table of Contents Medical Policy Development National Policies National Coverage Determinations National Coverage Provisions in Interpretive Manuals Local Policies [...]

Help with Medicare Costs

Help with Medicare Costs Medicare Savings Programs Learn about your options for help with Part B premiums Costs for Medicare Drug Coverage Learn how to get extra help with Part D Revised 11/1/2024

Don’t Wait Until 11/18/2024 To Use NGSConnex for Beneficiary Eligibility Information

Don’t Wait Until 11/18/2024 To Use NGSConnex for Beneficiary Eligibility Information  As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary [...]

Report a Change of Tax ID (Other than Change of Ownership)

Step 1: Determine You are in the Right Place If you are currently an enrolled health care organization that is changing your Tax ID and the change does not involve a change of ownership, it is essential that you report changes of Tax ID within [...]

Report a Change of Tax ID (Other than Change of Ownership)

Step 1: Determine You are in the Right Place If you are currently an enrolled health care organization that is changing your Tax ID and the change does not involve a change of ownership, it is essential that you report changes of Tax ID within [...]

Report a Change of Tax ID (Other than Change of Ownership)

Table of Contents Step 1: Determine You are in the Right Place Step 2: Complete the Medicare Application Step 3: Submit Required Documentation Related Content [Return to Top] Step 1: Determine You are in the Right Place If you are [...]

Mission and Charter

​​National Government Services Provider Outreach and Education Advisory Group Charter National Government Services serves as the MAC for J6 and JK Part A, Part B and Home Health and Hospice. We maintain four POE AGs: Part A POE [...]

Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service

Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service  Medicare Part B electronic claims (ANSI X12 837P) with total charges exceeding $99,999.99 cannot be processed in the MCS. If a single claim [...]

MLN Connects® Newsletter: October 31, 2024

MLN Connects® Newsletter: October 31, 2024 News Medicare Shared Savings Program Continues to Deliver Meaningful Savings and High-Quality Health Care Compliance Major Hip & Knee Replacement or Reattachment of Lower Extremity: [...]

11/4/2024

This is Our Last Self-Service Pulse We sincerely thank you for being a loyal reader of our Self-Service Pulse each week. To continue receiving updates on our latest self-service tools and services, please subscribe to our general Email [...]

Report a Change of Ownership, Acquisition/Merger or Consolidation

Table of Contents Step 1: Determine You Are in the Right Place Step 2: Understand Type of CHOW Change of Ownership Acquisition/Merger Consolidation CHOW Reminders Step 3: Make Changes via Enrollment Application Change of [...]

Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information

Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary eligibility [...]