National Government Services Medicare Administrative Contractor Provider Intervention Program

Are you aware that National Government Services has a MAC MPIP? The goal of this program is to notify you of potential billing aberrancies found as a result of data analysis and to reduce the rate of improper payments by giving Medicare providers the information they need to understand the Medicare Program and the potential behaviors identified before further action is taken.

If you are contacted by NGS' MPIP CMT, please make the time to work with them so an educational call can be scheduled where they will assist by providing what our data analysis shows, how your billing and payment of the behavior(s) identified compares to your peers (which will be demonstrated via a Comparative Billing Report), as well as providing references such as websites, LCDs, NCDs and billing and coding articles to further assist you.

After the education is provided, data will continue to be monitored to ensure that the behavior(s) you were educated on is improving, and eventually stopped. If it is found that the behavior continues, further action may be taken, which can become burdensome for providers if they are required to submit medical documentation in order for their claims to be reviewed, paid, and/or denied accordingly.

NGS is committed to educating providers to ensure compliance with Medicare coverage, coding and billing guidelines. We strive to assist providers from having so much burden put on them when we are able to educate, and the end result is that the behavior(s) is corrected and/or stopped. If you are contacted by our team, please take the time to work with us. We look forward to collaborating with you on this effort.

Posted 12/6/2023