Did you know that you can save time and money by requesting a Part B clerical error reopening electronically via NGSConnex? You will save time because electronic submission is much quicker than paper submission by mailing and you will save money by cutting postage fees.
A reopening is a request for a claim adjustment due to a minor error or omission on the original claim. Many types of claims may be adjusted through an NGSConnex reopening without the need to submit an appeal through the redetermination process. You may adjust claim level details, line of service information or indicate a claim was billed in error.
Using NGSConnex to reopen a claim or initiate an adjustment due to an overpayment is quick and easy, just follow these simple steps:
You will receive a confirmation email from No.Reply@NGSMedicare.com to confirm your submission.
Note: A final claim determination must be issued on the original claim before you can initiate a reopening.
Examples of minor error or omissions that may be adjusted through NGSConnex include:
Note: Clerical errors do not include omissions or failure to bill for items or services. You cannot add items or services that were not previously billed. Third party payer errors do not constitute clerical errors.
If you billed a claim or claim line in error and received payment, initiate an overpayment adjustment using the Initiate Reopening feature in NGSConnex. You may adjust a line of service or you may indicate the entire claim was billed in error by simply clicking a checkbox.
If you have completed the one-time request to have all current overpayment(s) and future overpayment(s) satisfied via immediate recoupment, you will not need to complete additional steps related to the provider initiated overpayment. This process will also help you avoid interest from accruing on claim(s) overpayments. If you have not previously requested an immediate recoupment, you will receive a demand notice for the overpayment.
Watch this five-minute tutorial to learn how to initiate an NGSConnex reopening:
Revised 10/24/2018
Posted 5/18/2018
Note: Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material which is copyrighted by the AMA. You are forbidden to download the files unless you read, agree to and abide by the provisions of the copyright statement. Read the copyright statement now (you will be linked back to here).
CPT codes, descriptions, and other data only are copyright 2018 American Medical Association (or such other date of publication of CPT). All rights reserved. Applicable FARS/DFARS apply.