Applying for an Extended Repayment Schedule

Processing Drivers and System Claim Paths

Chapter I: Online System Terminology   Processing Drivers and System Claim Paths Purpose Claims that are filed through the FISS DDE Provider Online System follow a prescribed route referred to as a system claim path. Claim paths [...]

Claim Status and Location Codes

Chapter I: Online System Terminology Claim Status and Location Codes Purpose The purpose of the status and location is to route claims through FISS. The status describes the general condition of the claim (i.e., whether paid, denied, [...]

Local Coverage Determination Open Meeting Announcement

Local Coverage Determination Open Meeting Announcement Jurisdiction 6/Jurisdiction K Part A/Part B MAC To ensure the development of LCDs occurs through a public and open process, we are soliciting scientific evidence and other [...]

Appealing a Denied Claim

Appealing a Denied Claim At times, providers submit a claim that ends up being denied; the denial may include appeal rights. Providers can appeal all of their overpayment claims on one request for redetermination, which is the first level of [...]

MLN Connects® Newsletter: February 23, 2023

MLN Connects® Newsletter: February 23, 2023     News Hospital Price Transparency: Progress and Commitment to Achieving Its Potential Home Infusion Therapy Services Monitoring Report Immunosuppressive Drugs: Comparative [...]

MLN Connects® Newsletter: February 9, 2023

MLN Connects® Newsletter: February 9, 2023     News DMEPOS: Get Benefit Category Determinations Nurse Practitioners and Clinical Nurse Specialists: Update to List of National Certifying Bodies Help Address Heart Health [...]

MLN Connects® Newsletter: February 2, 2023

MLN Connects® Newsletter: February 2, 2023 News Aligning Quality Measures across CMS — The Universal Foundation Medicare Ground Ambulance Data Collection System: Portal to Report is Open Skilled Nursing Facilities: Care Compare January [...]

Let's Chat About Counseling to Prevent Tobacco Use

Let's Chat About Counseling to Prevent Tobacco Use Do you have questions on how to bill Medicare for tobacco counseling? Join us on 1/24/2023 for the opportunity to ask questions about coverage and billing for Medicare’s preventative service [...]

MLN Connects® Newsletter: January 5, 2023

MLN Connects® Newsletter: January 5, 2023 News COVID-19: Updated Vaccines for Children Ages Six Months – Five Years Advisory Panel on Hospital Outpatient Payment: Request for Nominations Certificates of Medical Necessity and DME [...]

MLN Connects® Newsletter: December 15, 2022

MLN Connects® Newsletter: December 15, 2022 News Opioid Treatment Programs: New Information for 2023 Part B Immunosuppressive Drug Benefit: Check Medicare Eligibility Home Health Quality Reporting Program: Get Final OASIS-E Instrument [...]

MLN Connects® Newsletter: December 1, 2022

MLN Connects® Newsletter: December 1, 2022 News CMS Urges Timely Patient Access to COVID-19 Vaccines, Therapeutics Quality Payment Program: Preview Your Performance Information by December 20 Clinical Laboratory Fee Schedule: CY 2023 [...]

MLN Connects® Newsletter: November 23, 2022

MLN Connects® Newsletter: November 23, 2022 News Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1 Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment Medicare [...]

MLN Connects® Newsletter: September 7, 2023

MLN Connects® Newsletter: September 7, 2023     News New Version of CMS.gov HHS Proposes Minimum Staffing Standards to Enhance Safety and Quality in Nursing Homes CMS Announces Resources and Flexibilities to Assist with [...]

MLN Connects® Newsletter: September 14, 2023

MLN Connects® Newsletter: September 14, 2023     News Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Roundup (Sept 8, 2023) New Provider [...]

Ambulatory Surgical Center Pass-Through Devices

Ambulatory Surgical Center Pass-Through Devices What is a Pass-Through Device? Pass-through status is determined for newly FDA-approved drug and device products on an individual basis. Drugs and devices qualifying for pass-through status [...]

MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023

MLN Connects® Newsletter: COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older – September 14, 2023     News COVID-19: Updated mRNA Vaccines for Patients 6 Months & Older Posted 9/14/2023

URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations

URGENT: Billing Reminders for OPPS Providers with Multiple Service Locations Table of Contents Urgent: Provider Compliance Required Effective 8/1/2023 Requirements Claim Filing Requirements Final Reminders Related Content [Return to [...]

MLN Connects® Newsletter: September 21, 2023

MLN Connects® Newsletter: September 21, 2023     News CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the State of Georgia Organ Transplantation Affinity Group: Strengthening [...]

MLN Connects® Newsletter: September 28, 2023

MLN Connects® Newsletter: September 28, 2023     News CMS Statement on Current Status of Blood Tests for Organ Transplant Rejection CMS Roundup (Sept 22, 2023) Cardiovascular Disease: Talk with Your Patients about [...]