Get Help Submitting an Appeal Hard Copy

Get Help Submitting an Appeal Hard Copy All levels of appeals may be submitted by mail. The only types of appeals submitted to National Government Services are reopening and redetermination requests. For information on other types of appeals, [...]

Request a Redetermination

Request a Redetermination The first level of appeal is the redetermination and is carried out by the MAC. Time limit to initiate = 120 days from date of receipt of the initial determination notice Time limit to complete the [...]

PC-ACE Roster Billing Guide

PC-ACE Roster Billing Guide Roster billing is a feature of PC-ACE that allows the provider to create many nearly identical claims for flu and pneumonia vaccines quickly. PC-ACE is now equipped for COVID-19 vaccine roster billing as well. [...]

Appeals Decision Tree

Appeals Decision Tree

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. Whenever possible the refund to Medicare should be [...]

Complete a Voluntary Refund

A voluntary refund is when you have self-identified you have been overpaid and you need to refund the excess funds to Medicare. All checks are made payable to National Government Services. All checks are made payable to National Government [...]

5010 Top Page for Part B

EDI Front End Rejection Code Lookup Tool To view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

Person(s) with Medicare

Person(s) with Medicare  Home Contacts & Resources Coverage & Billing Education Medicare Plans News

Cardiac Positron Emission Tomography Pricing Change

Cardiac Positron Emission Tomography Pricing Change Effective 1/1/2020 there nine CPT codes that describe PET as noted in the lists below. Of the nine listed codes, six (group 1) are new for 2020 and are contractor priced codes for the TC and [...]

Site Map

I Am Not Yet Enrolled in Medicare

You can only begin set up with EDI if you are a participating provider in the Medicare program.  If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines.If you have a [...]

Hospice Billing

Hospice Documentation

Accessing Eligibility for MDPP in NGSConnex

5010 top page

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the reject code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code [...]

5010 top page for Durable Medical Equipment

5010 277CA Reject Code Lookup ToolTo view easy-to-understand descriptions associated with the edit code(s) returned on the Status Information segment (STC) of the version 5010 277CA – Claim Acknowledgement, enter the following code information [...]

ASP Drug Form Description

ASP Drug Resources

Note: Codes that have a $0 (zero) fee schedule amount will not display a search result.Locality/Area and County Information for IllinoisLocality/AreaCounties12Bond, Calhoun, Clinton, Jersey, Macoupin, Madison, Monroe, Montgomery, Randolph, St. [...]

Ambulance Form Description