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Let’s Chat about Provider Enrollment Revalidation

Aug 27, 10:00 AM – 11:00 AM EDT

Website Navigation for Part A Providers

Aug 27, 11:00 AM – 12:30 PM EDT

Adjustments Involving Medicare Secondary Payer

Aug 28, 11:00 AM – 12:30 PM EDT
 
 
 
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NGSMedicare.com for home health + hospice providers

Medicare home health providers bring a wide array of skilled services directly to a patient’s residence to meet the needs of beneficiaries who are homebound. 

Medicare hospice agencies are dedicated to providing the highest level of comfort and care to beneficiaries diagnosed with terminal illnesses.

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Local Coverage Determination and Article revisions August - September 2019

Posted Aug 23, 2019


MLN Connects® for Thursday, August 22, 2019

Posted Aug 22, 2019


Ambulance Fee Schedule and Medicare Transports Booklet

Posted Aug 21, 2019


CMS to Begin Using MFA Process for Online Provider Enrollment System Applications

Posted Aug 21, 2019


MLN Connects® for Thursday, August 15, 2019

Posted Aug 15, 2019

Go to All Production Alerts

Hospice NOE RTPs for ZIP Codes


Date Reported

7/12/19

Status

Closed

Provider Type(s) Impacted

Hospice

Date Resolved

8/19/19

Reason Code(s)

32114

Claim Coding Impact

Hospice Notice of Elections (NOEs) Returned to Provider (RTP)

Description of Issue

NOEs submitted beginning 7/1/2019 are being RTP for the provider ZIP Code. The reason code the NOEs are receiving is 32114. It has been determined the issue is in the FISS and only impacting EMC submitted transactions.

National Government Services Action

After additional research, the problem was identified and NGS is working with FISS to ensure the Internal Facility Zip Code Switch is not set to validate the Facility Zip Code field for TOBs 8XA, 8XD and 8XE.

Provider Action

NGS offers this workaround, for the time being. Providers can add the FAC ZIP to the claim in FISS using DDE.

8/19/2019: Providers may now submit their RTPd claims.

Proposed Resolution/Fix

Fix installed 8/19/2019.

Provider Enrollment Alert ‒ Issues resulting from recent Provider Enrollment, Chain and Ownership System (PECOS) release.



Date Reported

6/30/19

Status

Closed

Provider Type(s) Impacted

All Provider Types

Date Resolved

7/19/19

Reason Code(s)

N/A

Claim Coding Impact

N/A

Description of Issue

On 6/30/2019, PECOS Release 7.37 was implemented. This release was prescheduled and designed to bring efficiencies to Medicare Administrative Contractors (MACs) and providers who use PECOS. While many aspects of the release were successful, a small component associated to changes made to existing and new group reassignments, was found to be problematic post-implementation. As a result, data flows from PECOS to the Multi-Carrier System (MCS) for these changes have been delayed for all MACs to proactively correct the identified issue.

CMS has assembled a team with accountability for resolving this issue. The team is working tirelessly to resolve the issue by July 16, 2019.

Potential Questions and Answers that you may have:

Q: Can I continue to submit enrollment applications?

A: Yes, please continue to submit applications as you do today. Internet-based PECOS applications are the quickest method of submission and processing, although you may submit either via Internet-based PECOS web or paper applications. Application processing will continue at each of the MACs as normal. Please also continue to respond to requests for additional information.

Q: My PECOS enrollment record has been approved, but when I attempt to enroll with EDI they indicate my provider/supplier is not present in the claims system. Is additional action needed on my part?

A: No, we will update this article when a fix has been deployed and at that time you can enroll with EDI.

Q: My PECOS enrollment record has been approved but when I submit claims, they cannot be processed because the NPI/PTAN is not present in the claims system. Is additional action needed on my part?

A: No, we will update this article when a fix has been deployed and at that time you can resubmit claims for processing.

National Government Services Action

  NGS has implemented the system fix devised by CMS.

Provider Action

Providers may now resubmit impacted claims for processing.

Proposed Resolution/Fix

CMS has assembled a team with accountability for resolving this issue. The team is working tirelessly to resolve the issue by 7/16/2019.

7/22/2019: A fix was implemented on Thursday, 7/18/2019. As above, providers may now resubmit impacted clams for processing.

Some Claims Submitted Electronically Between 6/14/2019 and 6/17/2019 via NGS EDI Gateway and NGSConnex Did Not Process [RESOLVED]


Date Reported

6/19/19

Status

Closed

Provider Type(s) Impacted

Jurisdiction K, Jurisdiction 6, Part A, HHH, FQHC and Part B


Date Resolved

6/20/19

Reason Code(s)

N/A

Claim Coding Impact

N/A

Description of Issue

Some claims that were submitted electronically between 5:00 p.m. ET Friday, 6/14/2019 through 5:00 p.m. ET Monday, 6/17/2019 via the NGS EDI Gateway and NGSConnex did not reach the claims systems for processing.


National Government Services Action

These claims were resubmitted 6/19/2019. As a result of the resubmission, new 277CAs were generated containing a new claim number (ICN/DCN).


Provider Action

Please do not resubmit claims sent during the affected time frame. If you receive a second 277CA for the claims submitted during the affected time frame, please disregard the original 277CA and the associated ICN/DCN. The resubmitted claims will have the original receipt date for processing.



Proposed Resolution/Fix

This issue has been resolved. All impacted claims have been successfully submitted for claims processing.


Go to All Upcoming Education

Aug 27

10:00 AM – 11:00 AM EDT
Let’s Chat about Provider Enrollment Revalidation

Aug 27

11:00 AM – 12:30 PM EDT
Website Navigation for Part A Providers

Aug 28

11:00 AM – 12:30 PM EDT
Adjustments Involving Medicare Secondary Payer

Aug 28

11:00 AM – 12:00 PM EDT
Provider Enrollment: Submitting Revalidations via PECOS

Aug 29

11:30 AM – 12:30 PM EDT
NGSConnex Open Questions and Answers
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