Overlap/Dispute Process

Billing Overlap/Dispute Resolution Process

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Billing Overlap/Dispute Resolution Process

An overlapping situation may occur between hospitals for inpatient stays, home health agencies, outpatient services and hospice agencies. Overlapping situations may also occur due to SNF or home health consolidated billing, or the POS submitted on physician claims where the SNF or home health has failed to properly discharge the beneficiary.

In situations where resolution cannot be met, please submit an RFA Form to National Government Services for assistance.

Required documentation to include with RFA Form:

  • Records of Admission and Discharge of patient stay
  • Signed Patient Transfer Form (If overlap exist)
  • Point of Contact made to overlapping facility (Must have at least three contacts made, must include an internal communication log with records)
  • Email, Phone, Fax or Mail acceptable (One of the three attempts must be written communication. Documentation of email or mail must be included in records)

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Mailing Addresses and Fax Number

Please submit the RFA form to NGS at:

Fax: (317) 841-4418 Attn: Dispute/Overlap

JK

National Government Services
Attn: Disputes/Overlaps
P.O. Box 6189
Indianapolis, IN 46206-6189

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J6:

National Government Services
Attn: Disputes/Overlaps
P.O. Box 6475
Indianapolis, IN 46206-6475

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You may contact the General Inquiries area at any time for questions:

JK:

  • HH+H - 866-289-0423
  • General inquiries - 888-855-4356

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J6:

  • HH+H/WI Region - 866-590-6728
  • HH+H/RHHI Region - 866-590-6724
  • General inquiries - 877-702-0990

Note: All request must pertain to a claim with dates of service that are within the timely filing guidelines. If the billing dispute pertains to a claim that is already past the timely filing limit, no action will be taken.

Reviewed 5/20/2024