Proper Submission of Reopening Requests

Proper Submission of Reopening Requests National Government Services has identified an issue where providers are submitting reopening requests to change or add diagnosis codes on paid claims. These reopening requests do not impact the outcome [...]

Fourth Quarter Top Ten EDI Institutional Edits

Fourth Quarter Top Ten EDI Institutional Edits Using data analysis, we’ve updated the Top Ten EDI Edits for the 2024 fourth quarter. Visit Quarterly Top Ten EDI Institutional Edits to view the edits, their description and learn what you can [...]

Using Nicotine Replacement Therapy for Smoking Cessation

Using Nicotine Replacement Therapy for Smoking Cessation Healthcare providers may choose to offer quit smoking medications to help reduce withdrawal symptoms and cigarette cravings, effectively doubling the chances of quitting successfully. [...]

Inpatient Admission Prior to Medicare Entitlement Job Aid

Inpatient Admission Prior to Medicare Entitlement Job Aid Pre-Entitlement Quick Steps Pre-entitlement is when a beneficiary is admitted as an inpatient to an acute care hospital prior to the beneficiary's Medicare entitlement effective date [...]

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2025 The January 2025 quarterly system release was implemented on 1/6/2025 with the following changes to the Claims Correction Submenu (03) DDE screen: MAP1704 [...]

Inpatient Psychiatric Facility

Inpatient Rehabilitation Facility

Obtaining Beneficiary Eligibility Information Through NGSConnex

Obtaining Beneficiary Eligibility Information Through NGSConnex  As a reminder, our Customer Service Representatives aren’t permitted to share eligibility information because it’s available through NGSConnex. We encourage new and [...]

Corporate Holiday Schedule

Corporate Holiday Schedule The National Government Services Provider Contact Centers will be closed in 2025 to observe the following corporate holidays: Date Corporate Holiday Observed Wednesday, January 1, 2025 [...]

Quarterly Credit Balance Reports No Longer Required

Quarterly Credit Balance Reports No Longer Required As of 12/1/2024, providers are not required to submit the Medicare Credit Balance Report (CMS-838) on a quarterly basis. However, to ensure that monies owed to Medicare are repaid in a timely [...]

Submitting a Prior Authorization Request

Submitting a Prior Authorization Request Table of Contents Submitting a Prior Authorization Request Documentation Requirements Documentation Checklist for Medical Professionals Supporting the Physician Certification Statement [Return [...]

Meeting Schedules

Meeting Schedules Jurisdiction 6: Illinois, Minnesota, Wisconsin Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Meeting Date/Time Provider Type Chairpersons [...]

National Government Services - Telehealth Extension 2025

National Government Services - Telehealth Extension 2025 Section 3207 of the American Relief Act, 2025 modified Section 1834(m) of the Social Security Act to extend the waiver of the geographic, site of service, and practitioner type [...]

J6 Part A

J6 Part A Member Name Facility State Albaitis, Susan DaVita Kidney Care Multiple states (ESRD) Anderson, Brian Advocate Aurora Illinois Anderson, Keith Southern Illinois Healthcare [...]

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year

Hospice Cap Self-Reporting Reminder for the 2024 Cap Year The Hospice Cap Self-Reporting for the 2024 Cap Year (10/1/2023–9/30/2024) is due no later than 2/28/2025. Hospice providers should submit the pro-forma calculation along with [...]

Hospice Cap Self-Reporting

Hospice Cap Self-Reporting Table of Contents Hospice Cap Self-Reporting Cap Year (10/1/XXXX–9/30/XXXX) Completing the Pro-Forma Submitting the Pro-Forma Repaying an Overpayment Requesting an Extended Repayment Plan [...]

Federally Qualified Health Center (All States)

Federally Qualified Health Center (All States) Member Name Facility State Banks, Amy Health Access Network, Inc. Maine Boyd-Gamson, Terry Santa Barbara County Public Health California [...]

Part A Content

Cost Report Contacts: IL, MN, WI, All FQHC: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME J6_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: Cost [...]

Part A Content

Cost Report Contacts: CT, ME, MA, NH, NY, RI, VT: Bobbi Jo Luciano, Manager Office: South Portland, ME Sharon Townsend Office: South Portland, ME JK_Cost_Report_Filing@anthem.com Mailing Address for USPS: National Government Services Attn: [...]