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Posting Date: 04/14/2021
Responding to an Additional Documentation Request
Responding to an Additional Documentation RequestMost recently, National Government Services has experienced an increasing volume of 56900 denials: medical records not submitted upon receipt of an ADR. In response to the lack of submission of [...]
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Posting Date: 04/14/2021
CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”
CGI Hosting an Upcoming Session on “Easier File Uploads for E-Filing in MCReF”Medicare Part A Cost Report: Easier File Uploads for e-Filing in MCReF Webcast:Date: Thursday 4/29/2021Time: 1:00–2:30 p.m. ETRegister today DescriptionMedicare [...]
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Posting Date: 04/12/2021
Behavioral Health Integration Services: Psychiatric Collaborative Care Model
Behavioral Health Integration Services: Psychiatric Collaborative Care ModelIntegrating behavioral health care with primary care (“behavioral health integration” or “BHI”) is an effective strategy for improving outcomes for the millions of [...]
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Posting Date: 04/07/2021
Checking the Status of Your Accelerated or Advanced Overpayment
Checking the Status of Your Accelerated or Advanced OverpaymentIf you requested an accelerated or advanced payment (AAP), then the overpayment amount is right at your fingertips. We would like to share some great tips on managing your accounts [...]
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Posting Date: 04/05/2021
COVID-19 Lump Sum Payments for RHCs and FQHCs
COVID-19 Lump Sum Payments for RHCs and FQHCsRHCs and FQHCs may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS, through your MAC, will pay you up front for COVID-19 vaccines and [...]
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Posting Date: 04/05/2021
Medicare Diabetes Maintenance Programs
Medicare Diabetes Maintenance ProgramsDiabetes management is an important topic to National Government Services. Patients diagnosed with diabetes may experience challenges with managing their diabetes and are more likely to experience many [...]
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Posting Date: 04/02/2021
Provider Enrollment: Submitting Claims Before the Effective Date
Provider Enrollment: Submitting Claims Before the Effective DateNational Government Services has noticed an increase of Part B claim submissions from Medicare enrolled group practices for rendering providers prior to receiving their approval [...]
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Posting Date: 03/25/2021
LCD and Article Updates for April 2021
LCD and Article Updates for April 2021New LCDs/ArticlesColon Capsule Endoscopy (CCE) (L38571)CCE is a noninvasive procedure that does not require air inflation or sedation and allows for minimally invasive and painless colonic evaluation. It is [...]
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Posting Date: 03/22/2021
About Appeals
About AppealsProviders and beneficiaries have the right to appeal claim determinations made by National Government Services. The purpose of the appeals process is to ensure the correct adjudication of claims. Appeals activities conducted by NGS [...]
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Posting Date: 03/23/2021
New Documentation Requirements for Filing Medicare Cost Reports
New Documentation Requirements for Filing Medicare Cost ReportsAttention: The FY 2019 Medicare IPPS final rule changed the required supporting documentation that must be submitted with the Medicare cost report. CMS also published MLN Matters [...]
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Posting Date: 03/18/2021
Provider Enrollment: Change in Practice Location
Provider Enrollment: Change in Practice LocationThe fastest way to update a provider enrollment record is through PECOS for the individual (NPI Type 1) or entity/group (NPI Type 2). PECOS allows you to edit, add and delete information according [...]
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Posting Date: 10/09/2020
COVID-19 Accelerated/Advance Payment Revised Repayment Terms
COVID-19 Accelerated/Advance Payment Revised Repayment TermsThe recently enacted Continuing Appropriations Act, 2021 and Other Extensions Act amended the repayment terms for the COVID-19 accelerated/advance payments. The changes to the [...]
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Posting Date: 03/29/2021
COVID-19: RHC and FQHC Lump Sum Payments
COVID-19: RHC and FQHC Lump Sum PaymentsRural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) may request lump sum payments for administering COVID-19 vaccines in advance of cost report settlement. CMS will pay you for [...]
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Posting Date: 03/30/2021
Responding to a Hospice ADR
Responding to a Hospice ADRNational Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed.When you receive an ADR, it is important to [...]
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Posting Date: 03/29/2021
Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021
Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After 1/1/2021CR12108Posted 3/29/2021
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Posting Date: 03/29/2021
Update to Rural Health Clinic (RHC) Payment Limits
Update to Rural Health Clinic (RHC) Payment LimitsCR12185Posted 3/29/2021
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Posting Date: 03/26/2021
Local Coverage Determination L33626: Psychiatric Partial Hospitalization Programs
Local Coverage Determination L33626: Psychiatric Partial Hospitalization ProgramsA psychiatric partial hospitalization is a distinct and organized intensive psychiatric outpatient treatment of less than 24 hours of daily care, designed to [...]
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Posting Date: 03/15/2021
Outpatient Prospective Payment System Payment Rate for HCPCS Code A9591
Outpatient Prospective Payment System Payment Rate for HCPCS Code A9591CMS identified an error with the January 2021 OPPS Pricer file where the OPPS payment rate for HCPCS A9591 was incorrect.The correct OPPS payment rate for A9591 [...]
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Posting Date: 03/09/2021
National Government Services Part A Medical Review Newsletter March 2021
National Government Services Part A Medical Review Newsletter March 2021The National Government Services Medical Review department would like to welcome you to our newest service; a regular newsletter. It is our hope that you will find [...]
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Posting Date: 03/08/2021
PTB Prescription Drug Management
Prescription Drug ManagementWe have received many questions as to what prescription drug management consists of in the new 2021 E/M Medical Decision Making table. The quick answer is that the concept of prescription drug management has not [...]
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