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Posting Date: 07/15/2021
MLN Connects® Newsletter for Thursday, July 15, 2021
MLN Connects® Newsletter for Thursday, July 15, 2021 View this edition as a: Webpage | PDF News Cognitive Assessment: Resources for Providers CMS Opens National Coverage Determination Analysis on Treatment for Alzheimer’s Disease [...]
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Posting Date: 07/29/2021
MLN Connects® Newsletter for Thursday, July 29, 2021
MLN Connects® Newsletter for Thursday, July 29, 2021 Hospital Price Transparency Stakeholder Webinar — August 11 View this edition as a: Webpage | PDF Compliance Ambulance Services & SNF Consolidated Billing Requirements: Avoid [...]
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Posting Date: 07/14/2021
MLN Connects® Special Edition for Tuesday, July 13, 2021
MLN Connects® Special Edition for Tuesday, July 13, 2021 CMS Proposes Physician Payment Rule to Improve Health Equity, Patient Access CMS is proposing changes to address the widening gap in health equity highlighted by the COVID-19 Public [...]
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Posting Date: 07/20/2021
MLN Connects® Special Edition for Monday, July 19, 2021
MLN Connects® Special Edition for Monday, July 19, 2021 CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity CMS is proposing actions to address the health equity gap, ensure consumers have the [...]
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Posting Date: 03/24/2022
MLN Connects® Newsletter for Thursday, March 24, 2022
MLN Connects® Newsletter for Thursday, March 24, 2022 ICD-10: Comment on Proposed Procedure and Diagnosis Codes News Additional Residency Positions: Apply by March 31 Long-term Care Hospitals: March Preview Period Ends April 6 [...]
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Posting Date: 03/25/2022
April 2022 LCD and Billing and Coding Article Updates
April 2022 LCD and Billing and Coding Article Updates LCDs Effective 4/1/2022 Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA) (L33559/A56737) The LCD was returned for comment from 6/3/2021 through [...]
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Posting Date: 03/31/2022
MLN Connects® Special Edition for Wednesday, March 30, 2022
MLN Connects® Special Edition for Wednesday, March 30, 2022 Fiscal Year 2023 Hospice Payment Rate Update Proposed Rule - Comment by May 31 On March 30, CMS issued a proposed rule (CMS-1773-P) that would provide routine updates to [...]
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Posting Date: 04/01/2022
New Evaluation and Management Frequently Asked Questions for Prolonged Services
New Evaluation and Management Frequently Asked Questions for Prolonged Services We’ve added new frequently asked questions to the Prolonged Services section of our E/M FAQs to clarify proper billing for CPT codes 99354-99356, 99358-99359, and [...]
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Posting Date: 04/04/2022
MLN Connects® Special Edition for Monday, April 4, 2022
MLN Connects® Special Edition for Monday, April 4, 2022 Biden-Harris Administration Announces a New Way for Medicare Beneficiaries to Get Free Over-the-Counter COVID-19 Tests On April 4, The Biden-Harris Administration announced that more [...]
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Posting Date: 04/06/2022
MLN Connects® Special Edition for Wednesday, April 6, 2022
MLN Connects® Special Edition for Monday, April 6, 2022 Eligible Individuals Can Receive Second COVID-19 Booster Shot at No Cost On April 6, CMS announced it will pay for a second COVID-19 booster shot of either the Pfizer-BioNTech or Moderna [...]
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Posting Date: 04/11/2022
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport The Repetitive, Scheduled Nonemergent Ambulance Transport Prior Authorization Model establishes a process through which a request for provisional affirmation [...]
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Posting Date: 04/15/2022
Increased Volume of Appeal Status Inquiries
Increased Volume of Appeal Status Inquiries National Government Services has seen an increase in pending reopenings and redetermination levels, resulting in cases being completed beyond the 60 calendar-day timeframe. We are sharing some [...]
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Posting Date: 04/19/2022
MLN Connects® Special Edition for Monday, April 18, 2022
MLN Connects® Special Edition for Monday, April 18, 2022 CMS Proposes Policies to Advance Health Equity & Maternal Health, Support Hospitals On April 18, CMS issued a proposed rule for inpatient and long-term hospitals that builds on the [...]
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Posting Date: 07/30/2021
MLN Connects® Special Edition for Thursday, July 29, 2021
MLN Connects® Special Edition for Thursday, July 29, 2021 4 Final FY 2022 Payment Rules Hospice Payment Rate Update: FY 2022 Final Rule IRF Prospective Payment System: FY 2022 Final Rule IPF Prospective Payment System: FY 2022 Final Rule [...]
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Posting Date: 04/01/2022
MLN Connects® Special Edition for Thursday, March 31, 2022
MLN Connects® Special Edition for Thursday, March 31, 2022 IPF & IRF Proposed FY 2023 Payment Rules Inpatient Psychiatric Facilities: Fiscal Year 2023 Proposed Rule — Submit Comments by May 31 Inpatient Rehabilitation Facilities: [...]
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Emergency Department
New Evaluation and Management Frequently Asked Question for Emergency Department We’ve added a new frequently asked question to the Emergency Department section of our E/M FAQs to further define how time can be used as a factor in billing [...]
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Posting Date: 05/11/2022
New Evaluation and Management Frequently Asked Question for Time-Based Services
New Evaluation and Management Frequently Asked Question for Time-Based Services We’ve added a new FAQ for E/M time-based services. Please define rules for using time to level-set a service in the inpatient setting. Answer: In [...]
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Posting Date: 05/11/2022
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice"
Early Bird Registration is Now Available for the Home Health and Hospice MAC Collaborative Summit "One Program, One Voice" The 2022 HH+H MAC Collaborative Summit: One Program, One Voice is now available for early bird registration. This huge [...]
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Posting Date: 05/12/2022
MLN Connects® Newsletter for Thursday, May 12, 2022
MLN Connects® Newsletter for Thursday, May 12, 2022 Biosimilars Curriculum: Resources for Teaching Your Students News Comprehensive Error Rate Testing Documentation Center Moved on April 13 Physicians, Teaching Hospitals, Physician [...]
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Posting Date: 03/29/2022
We’ve Rebranded!
We’ve Rebranded! National Government Services is excited to share we’ve refreshed our brand! Our new brand line Where Next Begins reflects Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More. Over the [...]
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Posting Date: 05/12/2022
Outpatient Claims with Reason Code W7120 Returned in Error
Outpatient Claims with Reason Code W7120 Returned in Error A system error caused the CMS to return the following outpatient claims with reason code W7120: Bill types 13X and 85X Designated surgical ranges 10000-69999 or 0000T-9999T [...]
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Posting Date: 08/03/2021
MLN Connects® Special Edition for Monday, August 2, 2021
MLN Connects® Special Edition for Monday, August 2, 2021 CMS Final Rule Improves Health Equity, Access to Treatment, Hospital Readiness, and COVID-19 Vaccination Data Reporting of Hospital Workers Hospital Inpatient Prospective Payment System [...]
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Posting Date: 06/21/2021
New Version of PC-ACE: July 2021
New Version of PC-ACE: July 2021 PC-ACE Version 5.1 contains several CMS mandates and product enhancements including but not limited to the items listed below. 12206 – FFS Coverage of Costs for Kidney Acquisitions in MW Hospitals for [...]
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Posting Date: 06/10/2021
Medicare University Scheduled Maintenance
Medicare University Scheduled Maintenance Due to scheduled maintenance, Medicare University will be unavailable beginning Tuesday, 6/15/2021 from 8:00 p.m–11:00 p.m. ET. As a result, the Medicare University will not be accessible. We [...]
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Posting Date: 03/25/2021
Billing and Coding for Tempus Next Generation Sequencing Panel
Billing and Coding for Tempus Next Generation Sequencing Panel The Tempus Next Generation Sequencing Panel must be submitted with CPT code 81479. CPT 81479 (unlisted molecular pathology procedure) will be individually reviewed. Posted [...]
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Posting Date: 05/04/2021
COVID-19 Accelerated and Advanced Payment YouTube Video
COVID-19 Accelerated and Advanced Payment YouTube Video National Government Services developed the Part B COVID-19 Accelerated and Advanced Payment, Repayment and Recoupment Process YouTube Video to address common questions we are receiving. [...]
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Posting Date: 07/15/2021
Proper Billing Units for HCPCS Code J7320
Proper Billing Units for HCPCS Code J7320 National Government Services has noticed improper billing units used for HCPCS code J7320, Hyaluronan or derivative, GenVisc 850, for intra-articular injection, 1 mg. GenVisc 850 is indicated for the [...]
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Posting Date: 04/22/2021
Oxygen Coverage and Documentation Requirements
Oxygen Coverage and Documentation Requirements Please review this YouTube video that was developed from the A/B and DME MAC’s collaborative webinar titled ‘Oxygen Coverage and Documentation Requirements’. This video is a collaborative [...]
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Posting Date: 06/08/2021
New NGSMedicare.com is Coming Soon
New NGSMedicare.com is Coming Soon We continue to listen and gain invaluable insight from you on our provider content website, NGSMedicare.com. Coming mid-Summer 2021, you will be able to see your feedback put into action. Posted 6/8/2021
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Posting Date: 06/14/2021
NGSConnex Now Offers One Stop Electronic Appeals Solution
NGSConnex Now Offers One Stop Electronic Appeals Solution Medicare Part A providers and HH+H providers who are located in Jurisdiction 6 and submit fee-for-service claims to National Government Services now have the ability to submit [...]
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Posting Date: 01/28/2021
MLN Connects® for Thursday, January 28, 2021
MLN Connects® for Thursday, January 28, 2021 Medicare Wellness Visits: Get Your Patients Off to a Heathy Start View this edition as a: Webpage | PDF News Care Compare: 2019 Preview Period Open through March 25 Open Payments Data [...]
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Posting Date: 01/27/2021
MACs will host a Multi-Jurisdictional CAC Meeting Regarding Epidural Interventions for Chronic Pain Management
Medicare Administrative Contractors will Host a Multi-Jurisdictional Contractor Advisory Committee Meeting Regarding Epidural Interventions for Chronic Pain Management Due to the public health crisis, this meeting will be held via [...]
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Posting Date: 02/04/2021
MLN Connects® for Thursday, February 4, 2021
MLN Connects® for Thursday, February 4, 2021 Improving Accuracy of Medicare Payments View this edition as a: Webpage | PDF News Improving Accuracy of Medicare Payments Cardiovascular Health: Medicare Covers Screening & Therapy [...]
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Posting Date: 02/18/2021
MLN Connects® for Thursday, February 18, 2021
MLN Connects® for Thursday, February 18, 2021 COVID-19: EUA for Antibody Treatment View this edition as a: Webpage | PDF News CMS Takes Further Steps to Ensure Medicare Beneficiaries Have Wide Access to COVID-19 Antibody Treatment [...]
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Posting Date: 02/25/2021
MLN Connects® for Thursday, February 25, 2021
MLN Connects® for Thursday, February 25, 2021 Medicare Secondary Payer: Billing for Services View this edition as a: Webpage | PDF News CMS Offers Comprehensive Support to the State of Texas to Combat Winter Storm Compliance [...]
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Posting Date: 03/04/2021
MLN Connects® for Thursday, March 4, 2021
MLN Connects® for Thursday, March 4, 2021 COVID-19 Vaccine Codes: EUA for Janssen Biotech View this edition as a: Webpage | PDF News COVID-19 Vaccine Codes: EUA Effective Date for Janssen Biotech Inc. COVID-19 Vaccine [...]
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Posting Date: 03/11/2021
MLN Connects® for Thursday, March 11, 2021
MLN Connects® for Thursday, March 11, 2021 Hospitals: Are You Using Your PEPPER Data? View this edition as a: Webpage | PDF News PEPPERs for Short-term Acute Care Hospitals Colorectal Cancer: Medicare Covers Screening [...]
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Posting Date: 03/25/2021
MLN Connects® for Thursday, March 25, 2021
MLN Connects® for Thursday, March 25, 2021 Home Health Payment Corrections View this edition as a: Webpage | PDF News Medicare Shared Savings Program: Application Deadlines for January 1, 2022, Start Date Repetitive, Scheduled [...]
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Posting Date: 08/25/2020
LCD and Article Updates for September 2020
LCD and Article Updates for September 2020 The medical policies and related articles can be found in our Medical Policy Center. Article update for August Billing and Coding: Bevacizumab and biosimilars (A52370) ICD-10-CM codes C22.0, C22.8 [...]
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Posting Date: 06/23/2020
LCD and Article Updates for June and July 2020
LCD and Article Revisions for June and July The medical policies and related articles can be found in our Medical Policy Center. New LCDs and Articles effective 7/1/2020 Multimarker Serum Tests Related to Ovarian Cancer Testing [...]
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Posting Date: 07/23/2020
LCD and Article Updates for August 2020
LCD and Article Revisions for August 2020 The medical policies and related articles can be found in our Medical Policy Center. Billing and Coding: Bevacizumab and biosimilars (A52370) Based on compendia review, ICD-10-CM codes C22.0, C22.8 [...]
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Posting Date: 08/26/2020
How to Find a Local Coverage Determination
How to Find a Local Coverage Determination As the MAC for J6 and JK, NGS is responsible for posting and maintaining LCDs and articles for many Medicare billed services. These LCDs and articles can be found at the Medical Policy Center. Please [...]
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Posting Date:
New Version of PC-ACE: January 2021
New Version of PC-ACE: January 2021 PC-ACE Version 4.9 contains several CMS mandates and product enhancements including but not limited to the items listed below. 11939 - Quarterly Update to the MPFSDB - October 2020 Update 11988 - [...]
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Posting Date: 03/12/2020
NGS Update on Fees for Code G2066
NGS Update on fees for code G2066 HCPCS code G2066 (Interrogation device evaluation[s], [remote] up to 30 days; implantable cardiovascular physiologic monitor system, implantable loop recorder system or subcutaneous cardiac rhythm monitor [...]
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Posting Date: 09/29/2020
LCD and Article Updates for October 2020
LCD and Article Updates for October 2020 LCD Revisions: Transcranial Magnetic Stimulation (L33398) The notice period was extended to end on 9/30/2020 and the Revision Effective date has been changed from 8/1/2020 to 10/1/2020. Billing and [...]
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Posting Date: 12/23/2020
LCD and Article Updates for December 2020 and January 2021*
LCD and Article Updates for December 2020 and January 2021* Revised Billing and Coding Articles December 2020 and January 2021 Billing and Coding: Bevacizumab and biosimilars (A52370) Based on compendia review, ICD-10 code C22.3 has been [...]
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Posting Date: 12/14/2020
Home Health Agency Change in Reimbursement – Medicare Patient’s Therapy Needs Have Not Changed
Home Health Agency Change in Reimbursement – Medicare Patient’s Therapy Needs Have Not Changed Ordering physicians should be aware that HHAs may be adjusting, or planning to revise, their therapy services in response to fears about decreased [...]
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Posting Date: 12/17/2020
From the Desk of the MAC Medical Directors: Caring for Medicare Patients is a Partnership
From the Desk of the MAC Medical Directors: Caring for Medicare Patients is a Partnership As a patient’s treating physician or nonphysician practitioner, you may order, refer and/or give health care services for your patient in partnership [...]
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Posting Date: 01/07/2020
Reminder: 2020 Payment Amounts for Immunization Administration Services Massachusetts Localities
Reminder: 2020 Payment Amounts for Immunization Administration Services Massachusetts Localities The 2020 PFS Final Rule requires National Government Services, as well as all MACs, to maintain for CY 2020, the CY 2019 national payment amounts [...]
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Posting Date: 02/20/2020
April 2020 Release "Dark Days" for the Common Working File Hosts
April 2020 Release "Dark Days" for the Common Working File Hosts For the upcoming April 2020 Release: For Production, CWF will be observing dark days starting Friday, 4/3/2020 through Sunday, 4/5/2020 to accommodate the anticipated duration [...]
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Posting Date: 10/19/2020
Evaluation and Management: Anticipated Changes for Office and Outpatient Services in 2021
Evaluation and Management: Anticipated Changes for Office and Outpatient Services in 2021 Pending confirmation in the upcoming CMS 2021 Final Rule, NGS is reminding Part B providers of expected changes to E/M guidelines for office and [...]
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Posting Date: 12/07/2020
Annual Participation Enrollment Period Extended to January 31, 2021
Annual Participation Enrollment Period Extended to January 31, 2021 NOTE: CMS is extending the 2021 Annual Participation Enrollment Program. The participation enrollment period will now end 1/31/2021, instead of 12/31/2020. Posted 12/7/2020
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Posting Date: 06/18/2020
Retirement of Noncovered Services and Category III CPT Codes LCDs and Articles
Retirement of Noncovered Services and Category III CPT Codes LCDs and Articles Effective 7/1/2020, National Government Services is retiring the Noncovered Services LCD (L33629) and Billing and Coding Article (A57812), and the Category III CPT® [...]
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Posting Date: 08/06/2020
Alert: Postcard Disguised as Official OCR Communication 8/6/2020
Alert: Postcard Disguised as Official OCR Communication 8/6/2020 National Government Services would like to make providers aware of an official notification sent out by the OCR regarding a mailing that was sent out attempting to make providers [...]
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Posting Date: 04/07/2020
Adopting Appropriate Claim Denials Management System: Modifiers 76/77
Adopting Appropriate Claim Denials Management System: Modifiers 76/77 We have identified providers who are submitting several appeals for modifiers 76 and/or 77 and this has caused additional work for your organization as well as National [...]
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Posting Date: 02/07/2020
Adjustment on Payments for Outpatient Clinic Visit Services at Excepted Off-Campus Provider-Based Departments
Adjustment on Payments for Outpatient Clinic Visit Services at Excepted Off-Campus Provider-Based Departments The American Hospital Association challenged CMS’ use of its authority under Subsection (t)(2)(F) of the Medicare statute to pay for [...]
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Posting Date: 09/29/2020
Issues with Medicare Beneficiary Submitted Claims ‒ We Need Your Help
Issues with Medicare Beneficiary Submitted Claims ‒ We Need Your Help National Government Services has seen an increase of Medicare beneficiary submitted claims that often times result in a negative outcome. While most Medicare fee-for-service [...]
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Posting Date: 06/16/2020
Changes in Guidance for E/M Telephone Services (99441-99443)
Changes in Guidance for E/M Telephone Services (99441-99443) We are informing providers of a recent revision in interpretation and guidance for use of CPT codes 99441-99443 for telephone E/M services. Since these telephone services have been [...]
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Posting Date: 02/10/2020
Change in Hospice Cap Review Timeline and Letter Changes
Change in Hospice Cap Review Timeline and Letter Changes National Government Services wants all hospice providers to be aware that we are changing the timing of the final hospice cap reviews. The final hospice cap review will [...]
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Posting Date: 04/06/2020
Call Center Will Not Close for Training on 4/10/2020 and 4/24/2020
Call Center Will Not Close for Training on 4/10/2020 and 4/24/2020 The Provider Contact Center will not be closing for training on 4/10/2020 and 4/24/2020 from 12:00-4:00 p.m. ET. Instead, we will keep our lines open to ensure you can continue [...]
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