Self-Service Pulse: What You Need To Know This Week
As your MAC, National Government Services wants to provide you with a comprehensive source containing the most current information available for our self-service tools.
Top Claim Errors for Part A Providers
Part A providers are able to access the top claim denials, rejections and returned to provider codes on our website.
From the Resources dropdown, select Claims and Appeals.
From the Claims and Appeals page, select Top Claim Errors.
On the Top Claim Error page, you can search by a search or reason code and/or type of error.
Once you locate the error you would like to view, select View Details.
You will receive a pop-up that will tell you what the error is and how to avoid this error in the future and how to correct it if you already have a claim with that error.
Requesting Part A Redeterminations in NGSConnex Reminder
Do you submit redetermination requests electronically via NGSConnex? If so, you are reminded that just like a written request you are required to indicate the specific service(s), including date(s) of the service and/or item(s) for which the redetermination is being requested.
Recently, NGS has been receiving redetermination requests submitted via NGSConnex where it is unclear what the requestor is appealing. In some cases, providers indicated they are appealing the entire claim however, in the “Reason for Appeal” field they are indicating the appeal is only for a specific procedure code or line item.
The “Appeal Entire Claim?” field should only be selected if you disagree with the initial determination for each claim line included on the claim. You are required to select the claim lines you are appealing in Step 3, by selecting the checkbox next to the claim line. If a claim line has been adjudicated and you agree with the determination, the claim line should not be included in the redetermination request.
If you need more detailed information on how to initiate a redetermination request via NGSConnex, access the NGSConnex User Guide.
How Do I Log Into the New NGS Medicare University?
- Go to Medicare University (https://ngsmedicareuniversity.litmos.com/account/login/?)
- Access from the NGSMedicare.com landing page or one of the icons within the NGSMedicare.com line of business page.
- If you had an account previously on Medicare University AND you have logged in within the past two years, you can log into the new Medicare University using your current username and password.
- Click I’ve forgotten my username/password on the Medicare University login page if you need to reset your password.
- You will need to send an email to Medicare.university@elevancehealth.com if you do not remember what your username is.
- If you have never had a Medicare University account or have not used Medicare University within the past two years, you will need to create a new account. To create a new Medicare University account, click Create Account on the Medicare University login page and follow the prompts on the “Medicare University Course Registration” page that loads.
Obtaining Claim Status Through the IVR
Claim status and detailed claim information can be obtained without calling the Provider Contact Center by using self-service technology, including the IVR system and NGSConnex. The IVR claim status (touch-tone 2) currently provides detailed claim information on many types of claim denials
Refer to the Interactive Voice Response User Guide for all available features:
Connect with us on LinkedIn
Connect with us on LinkedIn!
Posted 9/23/2024