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Posting Date: 09/13/2019
276 Claim Status Inquiry Near Real-Time Response
276 Claim Status Inquiry Near Real-Time Response We are excited to announce a process change for our Part A providers that will return a 277 Claim Status Inquiry Response in “near real time.” Beginning in October, 2019, we will return the 277 [...]
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Posting Date: 08/14/2019
Medicare Beneficiary Identifier Monthly Tip
Medicare Beneficiary Identifier Monthly Tip Are you receiving claim rejections because of an invalid beneficiary identifier? It could be that you are using the wrong characters on the MBI. The new Medicare number will not include the letters [...]
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Posting Date: 07/25/2019
Changes to National Government Services Local Coverage Determination Process
Changes to National Government Services Local Coverage Determination Process In accordance with Section 4009 of H.R. 34-21st Century Cures Act (Public Law No: 114-255), CMS is updating the “Medicare Program Integrity Manual” with detailed [...]
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Posting Date: 07/19/2019
Attention PIP Hospitals – Delay in Periodic Interim Payment (PIP) Payments
Attention PIP Hospitals – Delay in Periodic Interim Payment (PIP) Payments We have been informed that the biweekly PIP/Pass-Through payment cycle did not initiate as scheduled last night. Therefore, the biweekly payments will be delayed by one [...]
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Posting Date: 06/10/2019
Reminder: ZIP Code Needed on Claims with Flu Vaccine Codes
Reminder: ZIP Code Needed on Claims with Flu Vaccine Codes Medicare Part B requires the location where the service(s) are rendered to be included on the claim for every service payable under the MPFS. In Box 32 on the CMS-1500 claim form, [...]
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Posting Date: 06/13/2019
MLN Connects® for Thursday, June 13, 2019
MLN Connects® for Thursday, June 13, 2019 MLN Connects® for Thursday, June 13, 2019 View this edition as a PDF News DMEPOS Competitive Bidding - Round 2021: Register Now Medicare Shared Savings Program: Submit Notice of Intent to [...]
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Posting Date: 06/11/2019
EDI Front End Rejection Code Lookup Tool
EDI Front End Rejection Code Lookup Tool The EDI Front End Rejection Code Lookup Tool is a simple to use tool that provides a clear and understandable description of edit codes returned on the 277 Claims Acknowledgement (277CA). Using this [...]
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Posting Date: 10/10/2019
Center for Medicare and Medicaid Innovation Payments
Center for Medicare and Medicaid Innovation Payments Section 1115A of the Social Security Act established the CMMI within the CMS to test innovative payment techniques and service delivery models. This payment model is outside the normal [...]
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Posting Date: 12/09/2019
CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications
CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications CMS announced they utilize an MFA process for users of their Provider Enrollment Systems. MFA is a second layer of security used to [...]
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Posting Date: 08/23/2019
Local Coverage Determination and Article revisions August‒September 2019
Local Coverage Determination and Article revisions August‒September 2019 Please note that consistent with Change Request 10901, all coding information, national coverage provisions and Associated Information (Documentation Requirements, [...]
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Posting Date: 09/11/2019
Important Update for Skilled Nursing Facilities - CMS Updated the SNF PDPM Web Page
Important Update for Skilled Nursing Facilities - CMS Updated the SNF PDPM Web page The SNF PPS PDPM was implemented on 10/1/2019 to replace the Resource Utilization Group, Version IV (RUG-IV) for the SNF PPS. SNF PDPM will improve [...]
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Posting Date: 07/02/2019
Genetic Testing Fraud Scam Directed at Medicare Beneficiaries
Genetic Testing Fraud Scam Directed at Medicare Beneficiaries The U.S. Department of Health and Human Services Office of Inspector General is alerting the public about a fraud scheme involving genetic testing. Please review the Fraud Alert: [...]
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Posting Date: 12/16/2019
Ensure Referral Forms Include the MBI
Ensure Referral Forms Include the MBI Providers have expressed concern regarding referral forms that do not include the new Medicare number, the MBI, they receive from providers who have referred a Medicare beneficiary to them for services. [...]
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Posting Date: 06/14/2019
July 2019 Release Dark Days for the Common Working File Host
July 2019 Release Dark Days for the Common Working File Host For the upcoming July 2019 Release, CWF will be observing dark days starting Friday, 6/28/2019, through Sunday, 6/30/2019 to accommodate the anticipated duration of this activity and [...]
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Posting Date: 06/13/2019
July 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes
July 2019 Fiscal Intermediary Standard System Direct Data Entry Screen Changes The following updates will be made to existing screens and implemented on 7/1/2019. MAP1716 Claim page (6) – INIT DRG field will be displayed this is a 4-byte [...]
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Posting Date: 05/31/2019
July 2019 EDI Front-End Quarterly Release
July 2019 EDI Front-End Quarterly Release Please be advised that while the CMS-mandated quarterly release for July 2019 will be installed the weekend of 6/30/2019, the code set updates included with this release will not be effective in the [...]
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Posting Date: 12/10/2019
January 2020 Release "Dark Days" for the Common Working File Hosts
January 2020 Release "Dark Days" for the Common Working File Hosts For the upcoming January 2020 Release: New Year’s Day holiday – observed Wednesday, January 1st – No cycles (onlines available). CWF will be observing dark days starting [...]
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Posting Date: 10/01/2019
Center for Medicare and Medicaid Innovation Remittance Remark
Center for Medicare and Medicaid Innovation Remittance Remark Attention providers: If you are receiving a remark stating "CMMI" payment on your remittance this is regarding a QPP payment. Please direct any questions regarding QPP to [...]
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Posting Date: 10/01/2019
October is National Breast Cancer Awareness Month
October is National Breast Cancer Awareness Month Breast Cancer Screening and Mammography Breast cancer is one of the most common kinds of cancer in women. According to the U.S. Department of Health and Human Services, about one in eight [...]
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Posting Date: 08/07/2019
Important News from CGS, Jurisdiction B DME MAC: Prior Authorization Condition of Payment for Certain Power Mobility Devices
Important News from CGS, Jurisdiction B DME MAC: Prior Authorization Condition of Payment for Certain Power Mobility Devices If you have Medicare patients who are seeking prior authorization of a power mobility devices, please review the CGS [...]
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