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Posting Date: 01/29/2021
Bill Inpatient or Outpatient Services
Bill Inpatient or Outpatient Services To help avoid denials, National Government Services has compiled information regarding references that will aid in determining whether to bill inpatient or outpatient services. CMS Medicare Learning [...]
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Posting Date: 01/29/2021
Process for Requesting Medical Records
Process for Requesting Medical Records Additional Documentation Requests INITIAL ADR letters for CERT are sent to the address on file with the NSC for DMEPOS suppliers, or the MAC for the provider/supplier that billed/submitted the [...]
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Posting Date: 01/29/2021
Inpatient Psychiatric Certification/Recertification/Delayed Certification
Inpatient Psychiatric Certification/Recertification/Delayed Certification Physicians are required to certify the medical necessity of inpatient services. This is required on admission and if the service is needed for an extended period of [...]
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Posting Date: 01/29/2021
SNF Inpatient Stays
SNF Inpatient Stays The CERT contractor has seen increased denials of SNF inpatient stays due to missing or incomplete physician certification statement of medical necessity. Certification of medical necessity of inpatient skilled nursing [...]
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