Search Results - NGSMEDICARE

Posting Date: 10/24/2024

9/18/2024 Part B POE Advisory Group Meeting

9/18/2024 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Elizabeth Aldrich, Dawson Ballard, Doris Barnes, Aurelia Barraco, Sheila Bembeneck, Madelon Berger, Todd Bergstrom, Louise [...]

Posting Date: 10/24/2024

Notification of the 2025 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review

Notification of the 2025 Dollar Amount in Controversy Required to Sustain Appeal Rights for an Administrative Law Judge Hearing or Federal District Court Review The amount that must remain in controversy for ALJ hearing requests filed on or [...]

Posting Date: 10/24/2024

39910

Avoiding/Correcting This Error Verify billing. If appropriate, correct and resubmit the claim.

Posting Date: 11/08/2024

Introduction to Medicare Contractors

Medicare Administrative Contractors (MACs) are responsible for processing claims, managing policy and payment, and establishing regional policy guidelines. Are you aware that the Centers for Medicare & Medicaid Services (CMS) also uses several [...]

Posting Date: 10/24/2024

MLN Connects® Newsletter: October 24, 2024

MLN Connects® Newsletter: October 24, 2024 News CMS Roundup (October 18, 2024) Rural Health Clinic & Federally Qualified Health Center: Final CY 2024 Payment Policies Claims, Pricers, & Codes Home Health Consolidated [...]

Posting Date: 06/03/2021

PECOS Correct and Resubmit Application Instructions

PECOS Correct and Resubmit Application Instructions Login to PECOS and select the following: My Associates View Enrollment for applicable enrollment under Existing Associates Correct and Resubmit for applicable [...]

Posting Date: 10/25/2024

34538

Avoiding/Correcting This Error If this is correct: Follow MSP billing guidelines and submit the claim accordingly. If this is incorrect: As part of a provider’s eligibility verification process for Medicare beneficiaries, which is required to [...]

Posting Date: 10/25/2024

34538

Avoiding/Correcting This Error To avoid this error: When submitting your Medicare primary claim, report the reason Medicare is primary using claim coding in Prevent an MSP Rejection on a Medicare Primary Claim. To correct this [...]

Posting Date: 10/25/2024

34538

Avoiding/Correcting This Error To avoid this error: When submitting your Medicare primary claim, report the reason Medicare is primary using claim coding in Prevent an MSP Rejection on a Medicare Primary Claim. To correct this [...]

Posting Date: 10/25/2024

34538

Avoiding/Correcting This Error To avoid this error: When submitting your Medicare primary claim, report the reason Medicare is primary using claim coding in Prevent an MSP Rejection on a Medicare Primary Claim. To correct this [...]

Posting Date: 10/25/2024

38032

Avoiding/Correcting This Error If duplicate claim was submitted in error, no additional provider action is necessary. If it is determined that the claim was due to additional charges for a patient for a specific date of service, wait for the [...]

Posting Date: 10/25/2024

38032

Avoiding/Correcting This Error If duplicate claim was submitted in error, no additional provider action is necessary. If it is determined that the claim was due to additional charges for a patient for a specific date of service, wait for the [...]

Posting Date: 10/25/2024

38050

Avoiding/Correcting This Error Check your remittance advice or the claims processing system for a previously submitted/processed claim before submitting any new billing.

Posting Date: 10/25/2024

38105

Avoiding/Correcting This Error Verify billing and if appropriate, correct and resubmit the claim. To prevent this error on future claims: Ensure that the correct bill type is submitted once you have received all charges from all [...]

Posting Date: 10/25/2024

38200

Avoiding/Correcting This Error Always verify the status of a submitted claim before submitting another claim. Verify claim status using the IVR system, FISS/DDE or the NGSConnex online portal. Per CMS mandate, PCC representatives are not [...]

Posting Date: 10/25/2024

38200

Avoiding/Correcting This Error Always verify the status of a submitted claim before submitting another claim. Verify claim status using the IVR system, FISS/DDE or the NGSConnex online portal. Per CMS mandate, PCC representatives are not [...]

Posting Date: 10/25/2024

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim. To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

Posting Date: 10/25/2024

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim. To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

Posting Date: 10/25/2024

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim. To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

Posting Date: 10/25/2024

39721

Avoiding/Correcting This Error To have this claim considered for payment submit a new electronic billing with the requested information.

Posting Date: 10/25/2024

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

Posting Date: 10/25/2024

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

Posting Date: 10/25/2024

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

Posting Date: 10/25/2024

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

Posting Date: 10/25/2024

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

Posting Date: 10/25/2024

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

Posting Date: 10/25/2024

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

Posting Date: 10/25/2024

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

Posting Date: 10/25/2024

7K073

Avoiding/Correcting This Error If the beneficiary is entitled to Medicare Part B, an ancillary claim may be submitted to your MAC. Related Content Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

Posting Date: 10/25/2024

7K073

Avoiding/Correcting This Error If the beneficiary is entitled to Medicare Part B, an ancillary claim may be submitted to your MAC. Related Content Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

Posting Date: 10/25/2024

C7010

Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

Posting Date: 10/25/2024

C7010

Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

Posting Date: 10/25/2024

37364

Avoiding/Correcting This Error There was an issue with NOAs incorrectly editing for U537F. Once the system was fixed, NOAs could be resubmitted and subsequently processed. NOAs submitted late due to this issue may have affected more than one [...]

Posting Date: 10/25/2024

38031

Avoiding/Correcting This Error Verify the ‘from’ and ‘through’ dates, provider number, revenue codes, HCPCS codes, and line item date of service on the bill. If the claim is truly a duplicate; no action is necessary. Providers should develop [...]

Posting Date: 10/25/2024

38032

Avoiding/Correcting This Error Providers should develop and implement a process to ensure that duplicate claims are not being submitted. If the claim is truly a duplicate, no action is necessary. If this is not a duplicate and the provider [...]

Posting Date: 10/25/2024

38037

Avoiding/Correcting This Error Providers should develop and implement a process to ensure that duplicate claims are not being submitted. Verify the ‘from’ and ‘through’ dates, provider number, revenue codes, HCPCS codes and diagnosis codes [...]

Posting Date: 10/25/2024

38054

Avoiding/Correcting This Error Verify the claim history to determine the period of care claim that is causing the overlap If there are services that should have been included on a processed/paid claim, you must submit an adjustment (3X7 [...]

Posting Date: 10/25/2024

38055

Avoiding/Correcting This Error Verify the claim history using the FFS/DDE Provider Online system, your remittance advice and/or the CWF to determine the episode claim that is causing the overlap If there are services that should have been [...]

Posting Date: 10/25/2024

38200

Avoiding/Correcting This Error This reason code may be applied when an NOA and period of care claim are submitted at the same time or when an NOA and one is already in the system. If the NOA and claim were submitted at the same time, and no [...]

Posting Date: 10/25/2024

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Providers can see line details in NGSConnex and hover over the line item reason code(s) for [...]