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Medicare Monthly Review Part A and B
A Combined Part A and Part B Newsletter

 

September 2006  
MIR-2006-9AB

CPT five-digit codes, descriptions, and other data only are copyright 2007American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in CPT. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for data contained or not contained herein.   Applicable FARS/DFARS clauses apply.

In This Issue:

 

 

KEY

Part A & B Contents

Part A

Part B

Title

A

A

2007 Annual Update for the HPSA Bonus Payments

A

A

A New Provider Education Product

A

A

CMS Awards First Medicare Administrative Contract

A

A

CMS NPI September Roundtable

A

A

Correction to NPI Business Requirement

H

P, N

Coverage for Diabetes Screening Tests

A

A

Deficit Reduction Act of 2005, Nine-Day Payment Hold

H, E

A

Disaster Response Plan for Individuals with Kidney Failure

A

A

Disclosure Desk Reference for Provider Contact Centers

A

A

End of Contingency for ERA

A

A

Health Care Professional Training Program Facilitator Kit

A

A

Health Care Quality Leaders Join Forces

A

A

Important Guidance for NPI Usage on Medicare Claims

A

A

Medicare Appeals Process: Five Levels

A

A

New Site for Medicare Provider Service Toll-Free Numbers

H

P, N, I

Non-Application of Deductible for Colorectal Cancer Screening

A

A

NPI – Get It, Share It, Use It

A

A

NPI – Get It, Share It, Use It – Roundtable

A

A

NPI Changes for Transaction 835 and SPR

A

A

Part B versus Part D Drug Coverage

A

A

Preventive Services Web-Based Training

A

A

Problem with 270/271 Health Care Eligibility Inquiry

A

A

Remittance Advice Remark Code

A

A

Reporting of Service Units with HCPCS Codes

A

A

Scope of Work and Specialty Activities for Next MACs

A

A

Updated Web Site Wheels Now Available for Order


Key
Part A Contents
Part A
Title

S

Correction to SNF CB for Partially Covered Inpatient Claims

H, E

HCPCS Code Changes for RFD and Hospitals Billing EPO

H

Modification of CWF Editing for Interrupted LTCH Stays

S

Nursing Home Payments to Increase in 2007

S

SNF PPS Pricer Update

H, S

Taxonomy Codes to Identify Provider Subparts

A

Uniform Billing (UB-04) Implementation


Key
Part B Contents
Part B
Title

 

 

L

Clinical Laboratory Improvement Amendments (CLIA) Brochure

A

Correction to SNF CB Coding File

P, C

Denied Replacement Defibrillator Claims Lacking QR Modifier

A

Requirements to Implement the Revised CMS-1500

A

Transitional Use of Part B Drug CAP Resupply Option

P, O, R

Update of Radiopharmaceutical HCPCS Codes for PET Scans

 

 


 
Part A Contact Information

Automated IVR Inquiries 1 (877) 567-7205
Monday - Friday 6:00 a.m. to 6:00 p.m.
Saturdays 9:00 a.m. to 2:00 p.m.

These hours represent minimum availability. System access is generally available until 10:00 p.m. on weekdays and 6:00 p.m. on weekends.

Provider Inquiries : 1 (888) 855-4356
Monday & Friday 9:00 a.m. to 4:00 p.m.
Tuesday - Thursday 8:00 a.m. to 4:40 p.m.

You will be able to transfer to a provider representative only during these hours.Please have your provider number, the HIC number and service dates available when you call.

The Provider Inquiries TTY number for the Hearing Impaired is:
1 (877) 425--2370
Monday & Friday 9:00 a.m. to 4:00 p.m.
Tuesday - Thursday 8:00 a.m. to 4:00 p.m.

Beneficiary Inquiries:
English and Spanish 1-800-MEDICARE
(1-800-633-4227)
TTY for the Hearing-Impaired: 1 (877) 486-2048

Integrated Electronic Services (IES)
Technical Help Desk:
1 (866) 889-7322
Monday - Friday from 8:30 a.m. until 4:30 p.m.

Medicare Fraud Hotline:
To report fraud and abuse in the Medicare and Medicaid programs: 1(800) HHS-TIPS/1(800) 447-8477

The Hotline TTY Number for the Hearing-Impaired is: 1(877) 623-6190
Medical Director: Dr. Ted Triana 1(315) 442-4893

Part B New Jersey Contact Information

Beneficiary TDD:
(800) 992-0165
Beneficiary Telephone Inquiries & ARU:
(800) 633-4227
DMERC:
(866) 419-9458
EMC:
(866) 488-0546
Fax-on-Demand (FOD):
(888) 281-8586
Part B Provider IVR:
(877) 567-9235
Part B Provider Customer Service:
(888) 855-4346
Provider Enrollment:
(866) 309-0486
Provider TTY/TDD:
(888) 897-7542

Provider Enrollment Mail claims to :

Empire Medicare Services
Provider Enrollment
P.O. Box 69218
Harrisburg, PA 17106-9218

Empire Medicare Services
Provider Claims
P.O. Box 69201
Harrisburg, PA. 17106-9201

Part B Appeals & Correspondence
Empire Medicare Services
P.O. Box 69202
Harrisburg, PA 17106-9202

Part B New York Contact Information

Part B Provider Telephone Inquiries (STAR)
Claim Status and information, eligibility
deductible, pricing and seminar
information:

(877) 869-6504

 

Claim Entry (MTCE):
(631) 244-5300
Claim Entry (MTCE) Information:
(212) 476-7934
DMERC:
(866) 419-9458
EMC Technical Support Help Desk:
(866) 889-7322
Fax-on-Demand (FOD):
(866) 709-1905
General Provider Enrollment Information:
(866) 837-0241
Health Professional Shortage Area (HPSA)
and EMC Audit:
(315) 442-4600
IES Technical Help Desk:
(866) 889-7322
Provider TTY/TDD:
(866) 786-7155
   
Provider Enrollment
Empire Medicare Services
Reimbursement Dept.
P.O. Box 1200
Crompond, NY 10517-1200
Mail Assigned Claims to:
Empire Medicare Services
P.O. Box 100
Yorktown Heights, NY 10598
   
Unassigned Claims to :
Empire Medicare Services
P.O. Box 355
Crompond, NY 10517
Health Professional
Shortage Area (HPSA) & EMC Audit
Empire Medicare Services
P.O. Box 4716
Syracuse, NY 13221-4716

UPIN Directories (CD/ROM version)
Quality Assurance and Coordination Dept.
P.O. Box 1201
Crompond, NY 10517

Back Issue Requests
Empire Medicare Services,
MNB-Back Issues
800 2nd Avenue
3rd Floor
New York, NY 10017
Part B Appeals & Correspondence
Empire Medicare Services
P.O. Box 2280
Peekskill, NY 10566

Part A Key: A-All Providers, C-Community Mental Health Centers (CMHC), E-Renal Dialysis (ESRD) Providers, H-Hospitals, M-Home Health Providers, O-Comprehensive Outpatient Rehabilitation Facilities (CORF) and Outpatient Physical Therapy Providers, P-Hospice Providers, S-Skilled Nursing Facilities (SNF), NA-Not Applicable

Part B Key: A-All Providers, B-Ambulance, C-Cardiovascular, D-DMEPOS, E-Drugs & Biologicals, F-ASC, G-Anesthesia, H-Physical & Occupational Therapy, I-Beneficiaries, J-Insurers, K-Home Health Care, L-Laboratory, M-Medicine, N-Non-Physician Practitioner, O-Nuclear Medicine, P-Physicians, R-Radiology, S-Surgery, U-Urology, V-Chiropractor, W-Ophthalmology, X-Podiatry, Q-Oncology, NA-Not Applicable

 

This bulletin should be shared with all health care practitioners and managerial members of the provider staff. Bulletins are available at no cost from our Web site at www.empiremedicare.com.

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