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Posting Date: 10/31/2023
November 2023
In This Issue National Government Services Articles for Part A and Part B Providers Collaborative A/B/DME Therapeutic Shoes for Persons with Diabetes Webinar Decrease Burden and Combine Multiple PDFs in one Document Before Responding to [...]
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Posting Date: 11/01/2023
MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023
MLN Connects® Newsletter: Take Our Provider Survey Today - November 1, 2023 News Take Our Provider Survey Today Posted 11/1/2023
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Posting Date: 11/02/2023
MLN Connects® Newsletter: November 2, 2023
MLN Connects® Newsletter: November 2, 2023 News CY 2024 Home Health Prospective Payment System Final Rule CY 2024 End-Stage Renal Disease Prospective Payment System Final Rule Behavioral Health: Medicare Pays for 3 Services [...]
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Posting Date: 11/03/2023
MLN Connects® Newsletter: PFS, OPPS/ASC, & OPPS 340B-Acquired Drug Final Rules - November 2, 2023
MLN Connects® Newsletter: PFS, OPPS/ASC, & OPPS 340B-Acquired Drug Final Rules - November 2, 2023 Final Rules CMS Finalizes Physician Payment Rule that Advances Health Equity CMS Makes Hospital Prices More Transparent and Expands [...]
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Posting Date: 02/02/2021
Who May File an Appeal
Who May File an Appeal Table of Contents Who May File an Appeal Appointment of Representative When Is an Appointment Not Necessary? Who May Be a Representative How to Make and Revoke an Appointment Required Elements When to Submit the [...]
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Posting Date: 02/02/2021
Submit an Appeal Electronically with NGSConnex
Submit an Appeal Electronically with NGSConnex Table of Contents Submit an Appeal Electronically with NGSConnex Step 1: Access NGSConnex Step 2: Submit an Electronic Appeal and Attach Documentation Step 3: Attach Documentation [...]
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Posting Date: 08/11/2021
Get Help Submitting an Appeal Hard Copy
Get Help Submitting an Appeal Hard Copy Table of Contents Get Help Submitting an Appeal Hard Copy Step 1: Complete the Appeals Request Form Helpful Tips: [Return to Top] Get Help Submitting an Appeal Hard Copy All levels of appeals [...]
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Posting Date: 02/24/2022
Reopenings for Minor Errors and Omissions
Reopenings for Minor Errors and Omissions Table of Contents Reopenings for Minor Errors and Omissions Reopening Facts What is a Clerical Error? Clerical Error and Omission Reopening Request Request a Reopening - NGSConnex Request a Reopening - [...]
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Posting Date: 11/03/2023
Overpayment: How Should I Respond?
Table of Contents Overpayment: How Should I Respond? What Action Should I Take? Complete a Voluntary Refund Where Should I Send my Forms and Payments? [Return to Top] Overpayment: How Should I Respond? An overpayment may be [...]
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Posting Date: 02/02/2021
What Documents are Needed
What Documents are Needed Table of Contents What Documents are Needed Supporting Medical Records Ambulance Ambulatory Surgery, Operating Room, Lithotripsy and Preadmission Testing Cardiac Rehabilitation Clinic and Therapeutic [...]
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Posting Date: 03/23/2015
Medicare Provider & Supplier Search
Medicare Provider & Supplier Search Search the CMS Website Find a doctor Find a supplier Search the National Government Services Website Medicare Participating Physicians Directory
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Posting Date: 12/19/2016
Social Security Administration Resources
Social Security Administration Resources Common Issues Handled by the Social Security Administration The following Medicare-related issues are the responsibility of the Social Security Administration (SSA) and should be handled by your local [...]
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Posting Date: 10/07/2010
Social Security Administration
Social Security Administration All Medicare/Social Security-related questions are handled by the closest Social Security office in each Congressional district for each state. The following describe reasons to contact the SSA regarding [...]
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Posting Date: 04/26/2023
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating
Tobacco Cessation Counseling Doesn’t Have To Be Lengthy or Intimidating Did you know that tobacco cessation counseling is a covered Medicare service? Brief tobacco counseling provides substantial health benefits while producing cost savings. [...]
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Posting Date: 11/06/2023
Common Definitions for Claim Submission Types
Common Definitions for Claim Submission Types Appeals An appeal is an independent review of the initial or revised determination. Proceeding with an appeal is the responsibility of the provider. Overall there are five levels of appeal the [...]
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Posting Date: 10/10/2022
The Great American Smokeout is Coming!
The Great American Smokeout is Coming! As a health care professional who provides care to patients with Medicare, you can help protect the health of your patients by encouraging them to take advantage of Medicare-covered preventive services, [...]
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Posting Date: 01/26/2015
State Health Insurance Assistance Program
State Health Insurance Assistance Program The State Health Insurance Assistance Program (SHIP) is a national program available in all states that offers free and unbiased one-on-one counseling and assistance to People with Medicare and [...]
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Posting Date: 06/04/2020
Beneficiary Contact Center
Beneficiary Contact Center People with Medicare have a single Medicare point-of-contact at: 1-800-MEDICARE 1-800-633-4227 TTY/TDD: 1-877-486-2048 1-800-MEDICARE connects you to a seamless network of customer service entities that [...]
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Posting Date: 09/16/2020
Using Touch-Tone
Using Touch-Tone Table of Contents Using Touch-Tone Using Touch-Tone for Alpha-Numeric Elements Using Touch-Tone to Enter a Letter [Return to Top] Using Touch-Tone The IVR is programmed to allow for the entry of all data [...]
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Posting Date: 09/16/2020
Claim Status <2>
Claim Status <2> If you are part of a group, remember to use the group NPI, PTAN and TIN for authentication purposes. When Claim Status is selected, the IVR will request and collect the following elements: NPI PTAN Last five [...]
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Posting Date: 09/16/2020
Checks <3>
table, td, th { border: 1px solid black; } table { border-collapse: collapse; width: 50%; } Checks <3> Table of Contents Checks <3> My Checks Information Checks Navigation Check Number Check Status [...]
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Posting Date: 09/16/2020
Offsets <4>
table, td, th table { border-collapse: collapse; width: 50%; } Offsets <4> Upon selecting Offsets, the provider will need to authenticate the following information: NPI PTAN Last five digits of the TIN Next, a submenu will [...]
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Posting Date: 11/08/2023
Set Up an Extended Repayment Schedule
If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]
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Posting Date: 11/08/2023
Set Up an Extended Repayment Schedule
If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]
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Posting Date: 11/08/2023
Set Up an Extended Repayment Schedule
If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted immediately. While you may request an ERS at any time during the debt-collection process, timely submission of a valid request [...]
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Posting Date: 11/08/2023
Provider Enrollment: Reminder for Open Enrollment and Participation Agreement
Provider Enrollment: Reminder for Open Enrollment and Participation Agreement The 2024 Annual Participation Open Enrollment Period is approaching for another year. While this is an important time (from mid-November to December 31) for [...]
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Posting Date: 09/16/2020
Provider Enrollment <6>
table, td, th table { border-collapse: collapse; width: 50%; } Provider Enrollment <6> When Provider Enrollment is selected, the IVR will request and collect the following information: Case number (If case number is unavailable, [...]
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Posting Date: 09/16/2020
Appeals <7>
table, td, th table { border-collapse: collapse; width: 50%; } Appeals <7> When the Appeals option is selected, the IVR will request and collect the following elements: Provider authentication elements: NPI PTAN TIN Note: [...]
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Posting Date: 09/16/2020
General Information <8>
table, td, th table { border-collapse: collapse; width: 50%; } General Information <8> When the general information option is selected, the IVR will prompt you to choose from the following options: Phone numbers Addresses [...]
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Posting Date: 09/16/2020
Phonetic Alphabet
table, td, th table { border-collapse: collapse; width: 50%; } Phonetic Alphabet To assist you when speaking terms that are alpha-numeric, we have implemented the phonetic alphabet. When speaking an alpha character, please use the either [...]
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Posting Date: 09/16/2020
Using Touch-Tone
Using Touch-Tone The IVR is programmed to allow for the entry of all data using touch‐tone in the event the user is unable to successfully speak to the IVR. These instructions detail how to use touch‐tone to enter various types of information [...]
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Posting Date: 09/16/2020
Checks <3>
table, td, th table { border-collapse: collapse; width: 50%; } Checks <3> If you are part of a group, remember to use the group NPI, PTAN and TIN for authentication purposes. Upon selecting Checks, the provider will need to [...]
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Posting Date: 09/16/2020
Remittance Statements <4>
table, td, th table { border-collapse: collapse; width: 50%; } Remittance Statements <4> Upon selecting Remittance Statements, the provider will need to authenticate the following information: NPI PTAN Last five (5) digits of [...]
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Posting Date: 09/16/2020
Patient Status <6>
table, td, th table { border-collapse: collapse; width: 50%; } Patient Status <6> When Patient Status is selected, the IVR will request and collect the following information: NPI PTAN TIN Once the authentication elements [...]
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Posting Date: 09/16/2020
Appeal Status <7>
Appeal Status <7> When Appeal Status is selected, the IVR will request and collect the following information: NPI PTAN TIN HICN or MBI Refer to the Phonetic Alphabet for assistance with speaking alpha characters [...]
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Posting Date: 11/08/2023
Determine Beneficiary Responsibility on an MSP Claim
Table of Contents Determine Beneficiary Responsibility on an MSP Claim Step 1: Review the Remittance Advice Step 2: Assess the Beneficiary’s Responsibility The MSP Patient Responsibility Formula: The Beneficiary’s Responsibility on [...]
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Posting Date: 11/09/2023
MLN Connects® Newsletter: November 9, 2023
MLN Connects® Newsletter: November 9, 2023 News CMS Roundup (Nov 3, 2023) Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now American Indians or Alaska Natives: Help Your Patients Achieve Optimal [...]
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Posting Date: 05/03/2022
Vein Ablation and Related Services
General Documentation Requirements for Vein Ablation and Related Services Checklist of prior authorization request (PAR) information to include: Doppler ultrasound results Documentation stating presence or absence of DVT (deep vein [...]
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Posting Date: 03/17/2016
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders
Electrical Stimulation Therapy: Important Coverage and Documentation Reminders Table of Contents CPT/HCPCS: 97032 Coverage and Documentation Provider Actions Related Content [Return to Top] CPT/HCPCS: 97032 National Government [...]
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Posting Date: 02/26/2016
Documentation Reminder: Psychiatry and Psychology Services
Documentation Reminder: Psychiatry and Psychology Services Table of Contents Documentation Reminder: Psychiatry and Psychology Services Submitting Documentation Provider Actions Related Content [Return to Top] Documentation [...]
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