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Posting Date: 04/04/2024
New Provider Center
New Provider Center National Government Services: A Medicare Administrative Contractor – Who Are We? A MAC is a private health care insurer to whom the CMS has awarded geographic jurisdiction to process FFS Medicare claims for beneficiaries [...]
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Posting Date: 11/07/2024
November is Lung Cancer Awareness Month
November is Lung Cancer Awareness Month Lung cancer is the leading cause of cancer death in the United States and worldwide. Although education, research and treatment options for lung cancer have dramatically improved in recent years, lung [...]
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Posting Date: 11/07/2024
Registration Now Open for the 2024 Preventive Services Virtual Conference!
Registration Now Open for the 2024 Preventive Services Virtual Conference! We are thrilled to announce that registration is now open for the National Government Services Medicare Part B 2024 Preventive Services Virtual Conference, taking place [...]
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Posting Date: 01/05/2024
Intensive Outpatient Program
Intensive Outpatient Program Table of Contents IOP vs. Partial Hospitalization Program Provider Types Eligible to Provide IOP Medicare Beneficiary Eligible for IOP Services Active Treatment and Treatment Plan Covered IOP Services [...]
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Posting Date: 11/03/2020
Introduction
Section 1: Introduction Introduction Disclaimer National Government Services produced this material as an informational reference for providers furnishing services in our contract jurisdiction. NGS employees, agents and staff make no [...]
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Posting Date: 11/03/2020
Federal Government Administration
Section 1: Introduction Table of Contents Federal Government Administration Who Is CMS? CMS' Goals Program Objectives Access to Quality Care Services to Beneficiaries Program Administration CMS Structure CMS [...]
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Posting Date: 04/28/2015
Fundamentals of Medicare: State Responsibilities
Section 1: Introduction State Responsibilities Facilities desiring to participate in either the Medicare or Medicaid programs must meet participation conditions for certification. State agencies certify to the DHHS whether providers satisfy, [...]
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Posting Date: 02/18/2014
Fundamentals of Medicare: Participating Providers
Section 1: Introduction Participating Providers Providers receiving Medicare reimbursement are known as “participating providers.” To become a participating provider, a provider must be in compliance with applicable provisions of Title VI of [...]
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Posting Date: 11/03/2020
Voluntary and Involuntary Termination of Provider Agreement
Section 1: Introduction Voluntary and Involuntary Termination of Provider Agreement Table of Contents Voluntary and Involuntary Termination of Provider Agreement Voluntary (Provider-Requested) Termination of Agreement Involuntary [...]
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Posting Date: 04/28/2015
Disclosure of Health Insurance Information
Section 1: Introduction Disclosure of Health Insurance Information Providers have restrictions on the information that they may disclose. The CMS IOM, Publication 100, Medicare General Information, Eligibility and Entitlement Manual, Chapter [...]
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Posting Date: 04/24/2015
Privacy Act
Section 1: Introduction Privacy Act The purpose of the Privacy Act of 1974 (Act), Title 5, United States Code, Section 552a, is to balance the government’s need to maintain information about individuals with the rights of individuals to be [...]
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Posting Date: 02/14/2014
National Provider Identifier
Section 1: Introduction National Provider Identifier The NPI is a HIPAA Administrative Simplification standard. The NPI is a unique identification number for covered health care providers that have replaced the legacy provider number. [...]
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Posting Date: 11/03/2020
Legacy Provider Numbers/Provider Transaction Access Numbers (PTANs)
Section 1: Introduction Legacy Provider Numbers/Provider Transaction Access Numbers Table of Contents Legacy Provider Numbers/Provider Transaction Access Numbers State Code Facility Type Third-Digit Specialty Unit Designations [...]
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Posting Date: 05/31/2024
Medicare Administrative Contractors
Section 1: Introduction Medicare Administrative Contractors What's A MAC Who are the MACs Table of Contents Medicare Administrative Contractors Who Is National Government Services? The Focus of the Provider Outreach & Education [...]
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Posting Date: 04/24/2015
Fundamentals of Medicare: Information References
Section 1: Introduction Information References Table of Contents Information References Telephone Inquiries Interactive Voice Response Eligibility Information Claim Status Information Check and Remittance Information General [...]
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Posting Date: 04/24/2015
Fundamentals of Medicare: Glossary of Terms
Section 1: Introduction Glossary of Terms Beneficiary: An individual who is eligible for Medicare. Benefit Period: The way that Medicare measures the use of hospital and SNF inpatient days. Claim: A bill for services rendered by a provider [...]
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Posting Date: 04/24/2015
The History of Medicare
Section 2: Medicare Basics The History of Medicare During the 30 years following the passage of the SSA in 1935, many attempts were made to include health insurance as part of the Social Security system. It was not until the bill H.R. 6675 [...]
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Posting Date: 04/24/2015
What Is the Medicare Program and How Is It Funded?
Section 2: Medicare Basics What Is the Medicare Program and How Is it Funded? Medicare is a federally funded health insurance program for: People age 65 or older Certain individuals under age 65 who qualify due to disability People with [...]
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Posting Date: 04/24/2015
Medicare Eligibility and Premiums
Section 2: Medicare Basics Medicare Eligibility and Premiums The following groups of people are eligible for Medicare: Individuals aged 65 or older (or their spouse) who have worked at least 40 quarters, or ten years, in Medicare-covered [...]
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