Medical Policy Update – Part A/B Contractors
Process of Submission of Local Coverage Determination (LCD) Reconsiderations
Effective April 1, 2008
National Government Services is consolidating the process of submission of reconsiderations. The electronic submission of all documentation, by e-mail or fax, is preferred.
Please send LCD reconsideration written requests to:
National Government Services, Inc.
Medical Policy Unit
Attn: Gina Oliveri, RN – LCD Reconsideration Requests
P.O. Box 7149
Indianapolis , IN 46207-7149
E-mail: NGS.lcd.reconsideration@anthem.com
or
Fax: (888) 605-8802
Note: Justification supported by new evidence not previously considered in the creation of the LCD, which may materially affect the LCD’s content or basis, is required for all LCD reconsideration requests, including those made by e-mail, online form, and fax.
In addition, requestors must ensure that the sending of Medicare beneficiary HIC numbers, Medicare provider numbers, or any other individually identifiable health information is compliant with the privacy provisions found in the Health Insurance Portability and Accountability Act (HIPAA).
The requirements in this article are based on instructions found in CMS Publication 100-08, Medicare Program Integrity Manual, Chapter 13, Section 7.1, and 11.
For further information please refer to the Centers for Medicare & Medicaid Services (CMS), Medicare Coverage Center, Local Coverage Determination (LCD) Reconsideration Process Medical Policy Article (A47355).
http://www.cms.hhs.gov/center/coverage.asp
|