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Posting Date: 11/08/2022
Verify Bank Account Information
Verify Bank Account Information National Government Services receives numerous electronic funds transfer banking rejections each year due to frozen or closed bank accounts. To prevent interruption in Medicare payment, billing providers verify [...]
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Posting Date: 04/14/2021
Electronic Funds Transfer Form and Instructions
Electronic Funds Transfer Form and Instructions To initiate the EFT process, you will need to complete the Electronic Funds Transfer (EFT) Authorization Agreement (CMS-588). By signing the CMS-588 form, you are certifying the account is in [...]
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Posting Date: 04/30/2019
Electronic Funds Transfer
Electronic Funds Transfer EFT allows for claim payments to be electronically transferred to your bank in place of a hard copy check mailed to the facility. Medicare payments due a provider or supplier of services may be sent to a bank (or [...]
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Posting Date: 02/01/2021
Acknowledgement Email
Acknowledgement Email Upon receipt of your application submission, the contact person (identified on application) will receive an email confirmation from: CustomerService-DoNotReply@cms.hhs.gov containing the PECOS web tracking number. [...]
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Posting Date: 04/20/2021
Requests for Additional information
Requests for Additional information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]
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Posting Date: 08/27/2021
Site Visits
Site Visits Site visits may be required and will be unannounced; the contractor representatives must disclose to the provider appropriate identifying credentials and explain the purpose of the visit. CMS has implemented a site visit [...]
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Posting Date: 08/21/2018
Paper Enrollment Process
Paper Enrollment Process Enrollment via paper is an option, but PECOS is the preferred method to process the application with streamlining features. Paper-based enrollment applications are available. Determine which CMS Paper Form you will [...]
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Posting Date: 11/08/2019
Supporting Documents
Supporting Documents Attach required supporting documentation for individuals or organizations. Submit all applicable documents: CMS-588 EFT Authorization Agreement and voided check or bank confirmation letter IRS document confirming your [...]
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Posting Date: 02/02/2021
Requests for Additional Information
Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]
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Posting Date: 11/15/2020
Interactive Voice Response System
Interactive Voice Response System You may check the status of your provider enrollment application (PECOS or paper) submissions via the IVR by: Case number/web tracker id or NPI and TIN combination Related Content Interactive Voice [...]
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Posting Date: 11/05/2020
Check Provider Enrollment Application Status
Check Provider Enrollment Application Status You may run simple search queries to retrieve and view the status of your CMS-855 application via two options. Case number/web tracker id NPI and TIN combination Related Content Check [...]
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Posting Date: 08/21/2018
PECOS Self-Service Application Status
PECOS Self-Service Application Status You may run simple search queries to retrieve and view the status of your PECOS application. Individual ‒ View the enrollment application status of an individual provider in an organization or private [...]
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Posting Date: 02/02/2021
Approval or Denial
Approval or Denial Approval Once your application is approved, you will receive an emailed, faxed or mailed Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]
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Posting Date: 02/02/2021
Approval or Denial
Approval or Denial Approval Once your application is approved, you will receive an emailed, faxed or mailed Medicare letter with PTAN. Review this letter to ensure that everything is accurate and if you have any questions, please contact the [...]
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Posting Date: 06/04/2024
Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident (CRI)
Accelerated Payment Program Available for Providers Impacted by the Ascension Health Cyber Related Incident Part A Providers experiencing cash flow problems related to Ascension Health CRI, which began on 5/8/2024, may be eligible for [...]
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Posting Date: 10/07/2010
Medicare Information in Other Languages
Medicare Information in Other Languages Download Medicare & You in Spanish, 中文/Chinese, TIẾNG VIỆT/Vietnamese or 한국어/Korean. Español/Spanish 中文/Chinese 한국어/Korean TIẾNG VIỆT/Vietnamese Reviewed 6/13/2024
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Posting Date: 08/21/2018
Creating application in PECOS
Creating Application in PECOS Instructions to create an application in PECOS: Login to PECOS My Associates Create Initial Enrollment Application Note: There will be a series of questions to determine application descriptions tailored to [...]
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Posting Date: 04/20/2021
Requests for Additional Information
Requests for Additional Information While processing the application(s), National Government Services may determine additional information is needed. All requested information should be submitted as soon as possible, but no later than 30 days [...]
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Posting Date: 07/05/2022
Medical Review: Targeted Probe and Educate Review Topics
Medical Review: Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to [...]
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Posting Date: 02/09/2022
Targeted Probe and Educate Educational Videos
Targeted Probe and Educate Educational Videos Video Description Targeted Probe and Educate Learn more about the TPE Program. Additional educational information can be found on our Events page and [...]
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Posting Date: 07/05/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K Part A Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Debridement, subcutaneous tissue (includes epidermis and dermis, if performed) 11042, 11045 [...]
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Posting Date: 07/05/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 02/09/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K HHH Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Medical Necessity N/A 55H3V– The documentation did not support the medical [...]
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Posting Date: 02/04/2022
Best Practices for a Successful Targeted Probe and Educate Review
Best Practices for a Successful Targeted Probe and Educate Review Table of Contents Getting Started With TPE Notification Letter During the Review Process Post-Probe/Review Results Letter Prepare for Post-Probe Education [Return to [...]
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Posting Date: 06/20/2024
AFH_How to Proactively Address Denials
How to Proactively Address Denials How to Proactively Address Denials Want to improve the Payment Error Rate for the next round of review? Be sure to learn about and understand claim denials before the end of round education with the Case [...]
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Posting Date: 06/20/2024
MLN Connects® Newsletter: June 20, 2024
MLN Connects Newsletter: June 20, 2024 News CMS Preparing to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack Federal Study Examines Care Following Nonfatal Overdose Among Medicare [...]
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Posting Date: 05/17/2023
How to Prevent Common Skilled Nursing Facility Denials
How to Prevent Common Skilled Nursing Facility Denials This article was developed to increase awareness and educate SNFs on the top errors found by our Medical Review team. The information below includes suggestions to ensure documentation [...]
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Posting Date: 04/17/2024
Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident
Proper Medicare Part B Claim Submissions Due to the Change Healthcare Security Incident With many providers submitting paper claims due to the Change Healthcare security incident, it is important to submit your claims correctly. Failure to do [...]
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Posting Date: 05/03/2024
Join Us for ‘Real Time” with CMS Chicago
Join Us for ‘Real Time' with CMS Chicago The CMS Chicago LEA would like to invite you to our “Real Time” with CMS Chicago, a bi- weekly webinar that occurs on the 2nd & 4th Wednesday of every Month at 9 a.m. CT. These 30-minute calls are [...]
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Posting Date: 03/27/2015
SNFs: Missing Medicare Health Insurance Claim Number on Minimum Data Set Can Cause Potential Claim Denials
SNFs: Missing Medicare Health Insurance Claim Number on Minimum Data Set Can Cause Potential Claim Denials Our Medical Review department has noted many cases where the HIC number is missing from the MDS that is in the repository. MDS Overview [...]
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Posting Date: 09/08/2021
Billing Reminder: When a Skilled Nursing Facility Payment Ban is in Effect
Billing Reminder: When a Skilled Nursing Facility Payment Ban is in Effect CMS may impose a DPNA against the SNF when the facility is not in compliance with the requirements of participation under the Social Security Act at Sections 1819(h) [...]
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Posting Date: 05/09/2024
Get Your PS&R Reports
Table of Contents Get Your PS&R Reports Register to Receive the PS&R Report Instructions on How to Use Redesign Detail Reports [Return to Top] Get Your PS&R Reports The PS&R report is a tool used by Part A providers [...]
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Posting Date: 05/09/2024
Get Your PS&R Reports
The PS&R report is a tool used by Part A providers and MACs to prepare and process Medicare cost reports. Table of Contents Register to Receive the PS&R Report Instructions on How to Use Redesign Detail Reports [Return to Top] [...]
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Posting Date: 05/09/2024
Request a Due Date Extension
It may be necessary to request an extension for your cost report due date because of an extraordinary circumstance. An example of an extraordinary circumstance would be a flood or fire that forces a provider to cease operations and transfer [...]
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Posting Date: 05/09/2024
Request a Due Date Extension
It may be necessary to request an extension for your cost report due date because of an extraordinary circumstance. An example of an extraordinary circumstance would be a flood or fire that forces a provider to cease operations and transfer [...]
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Posting Date: 04/19/2024
Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024
Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024 Effective for hospice claim "From" dates on or after 5/1/2024, CMS implemented edits to enforce a new rule that would deny hospice claims if the certifying [...]
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Posting Date: 04/22/2024
Top Claim Errors Have Been Reviewed and Updated
Top Claim Errors Have Been Reviewed and Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors under Resources > Claims and Appeals to learn what you can do to avoid claim [...]
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Posting Date: 04/23/2024
Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex
Table of Contents Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex What are the benefits? [Return to Top] Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex National Government [...]
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Posting Date: 04/24/2024
Home Office Cost Statements
A home office of a chain organization is a related organization to its participating providers. Home offices usually furnish central management and administrative services, e.g., centralized accounting, purchasing, personnel services, [...]
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Posting Date: 05/09/2024
MLN Connects® Newsletter: May 9, 2024
MLN Connects® Newsletter: May 9, 2024 News HHS Releases New Data Showing Over 10 million People with Medicare Received a Free Vaccine Because of the President’s Inflation Reduction Act; Releases Draft Guidance for the Second Cycle of [...]
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Posting Date: 01/18/2022
Submission of a Medicare Cost Report Reopening Request
Submission of a Medicare Cost Report Reopening Request In accordance with CMS policy (42 Code of Federal Regulations 405.1885 and CMS IOM Publication 15-1, The Provider Reimbursement Manual, Section 2931), a provider may request a reopening of [...]
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Posting Date: 08/30/2021
CMS Medicare Administrative Contractor Information
CMS Medicare Administrative Contractor Information Note: Please do not include PHI such as Medicare numbers within emails. Navigation [Part A] [Part B] [DME MAC] [Federally Qualified Health Center] [Home [...]
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Posting Date: 01/12/2023
Physicians: Are You Ordering Knee Orthosis for Your Patients?
Physicians: Are You Ordering Knee Orthosis for Your Patients? This is your opportunity to hear directly from the Medicare contractors regarding documentation required for the coverage criteria to be met. You’ll also learn how to help your [...]
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Posting Date: 08/15/2022
Staying Up To Date on Vaccines
Staying Up To Date on Vaccines It's important to stay up to date on vaccines. Vaccines protect your patients from serious illness and can keep them out of the hospital. Talk with your patients about which vaccines may be right for them, many [...]
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Posting Date: 03/22/2024
Hospice Certifying Physician Medicare Enrollment Information
Hospice Certifying Physician Medicare Enrollment Information Under CMS' current regulations, the hospice medical director or the physician member of the hospice interdisciplinary group (the “hospice physician”) and the attending physician (if [...]
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Posting Date: 05/09/2024
File an Amended Cost Report
Table of Contents File an Amended Cost Report Timeframe to Amend the Medicare Cost Report [Return to Top] File an Amended Cost Report A provider may elect to submit an amended cost report subsequent to the initial filing. The Centers [...]
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Posting Date: 05/09/2024
Prepare and Submit a Cost Report
Table of Contents Prepare and Submit a Cost Report Submit Cost Report Documentation MCReF Other Electronic Media Formats Electronic Filing Requirements and List of Vendors Approved XML IRIS Vendors Home [...]
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Posting Date: 05/09/2024
File an Amended Cost Report
A provider may elect to submit an amended cost report subsequent to the initial filing. The CMS Medicare Paper-Based Manuals Publication 15-1, Provider Reimbursement Manual—Part I, Chapter 29 Section 2931.2A, allows the Medicare Administrative [...]
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Posting Date: 04/25/2024
MLN Connects® Newsletter: April 25, 2024 (UPDATE)
MLN Connects® Newsletter: April 25, 2024 (UPDATE) Editor's Note: CMS updated a message because we delayed the effective date that physicians who certify hospice services must enroll in or opt-out of Medicare until 6/3/2024. You may have to [...]
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Posting Date: 02/23/2017
What is NGSConnex?
What is NGSConnex? NGSConnex is a free, secure, web-based application developed by National Government Services just for you! NGSConnex provides access to a wide array of self-service functions that save you time and money, such as: Obtain [...]
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Posting Date: 04/29/2024
LCD and Article Updates for April/May 2024
LCD and Article Updates for April/May 2024 Billing and Coding Articles Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin (A59311) [...]
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Posting Date: 04/29/2024
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024)
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024) The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 4/25/2024 through [...]
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Posting Date: 05/09/2024
Request an Accelerated Payment
Medicare Part A guidelines provide for accelerated payments under highly exceptional circumstances. Accelerated payment criteria and eligibility requirements are outlined in the CMS Paper-Based Manuals Publication 15-1, Medicare Provider [...]
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Posting Date: 10/07/2010
PS&R/Cost Report Crosswalk
PS&R/Cost Report Crosswalk Did you know you have access to crosswalks between the PS&R Summary Report and the Medicare cost report? Our Medicare Audit and Reimbursement Department created crosswalk tools for hospitals and [...]
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Posting Date: 05/09/2024
Request an Interim Rate Adjustment
When requesting an interim rate adjustment, it's important to submit your interim financial data to National Government Services using the appropriate Interim Rate Review Documentation Request Form. These forms are designed to capture important [...]
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Posting Date: 05/09/2024
Request an Interim Rate Adjustment
When requesting an interim rate adjustment, it's important to submit your interim financial data to National Government Services using the appropriate Interim Rate Review Documentation Request Form. These forms are designed to capture important [...]
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