NGSConnex Details

Using NGSConnex for Claims Billed in Error

Did you know that NGSConnex registered users should be initiating a clerical error reopening in NGSConnex to correct minor errors or omissions, or to initiate an overpayment for services billed in error, when MSP is not involved?

Appropriate processes are essential for an effective provider organization and using appropriate workflows will assist National Government Services in more efficiently handling your requests; therefore, we ask that you refrain from using paper forms to correct minor errors or omissions or to initiate an overpayment for claims billed in error, when MSP is not involved. Instead, know that you can use NGSConnex to initiate a clerical error reopening to correct these claims.

Note: Clerical error reopenings are done on claims that may have underpayments or overpayments, when MSP is not involved.

Here are some types of clerical reopenings that are conducted via NGSConnex or the Part B Reopening Request Form and Large Various Adjustment Macro (LVAM):

  • Billing or Clerical Errors (Changes) 
  • Procedure code - Procedure codes J7187 – J7195, Q2023, Q2041 and Q4096 along with any procedure code ending in ‘99’ or any procedure code considered ‘not otherwise classified’ require documentation and cannot be processed as a clerical error reopening.
  • Units of service
  • Modifiers - Modifiers 22, 23, 52, 53, 54, 55, 62, 66, GA, GY and GZ require documentation and cannot be processed as a clerical error reopening.
  • Date of service
  • Place of service
  • Diagnosis code - If a claim or claim line has been submitted and paid, submitting a new, or corrected diagnosis does not qualify as a reopening.
  • Billed amount
  • Rendering practitioner NPI
  • Duplicate services (indicate total services rendered)
  • Services should not have been billed to the Medicare Program
    • Billed in Error
    • Not our patient(s)
    • Services Not Rendered
    • VA
    • Uniform Services Family Health Plan (USFHP)
    • HMO

The Part B MSP Overpayment Form is strictly for Medicare Secondary Payer overpayments.

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Posted 10/24/2022