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Posting Date: 02/12/2025
FQHC Claim Hold Effective DOS 1/1/2025
CMS has issued claim hold instructions to all MACs, due to release and testing of a new FQHC pricer.
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Posting Date: 02/13/2025
[RESOLVED] Medicare Claim Process System Experiencing Outages
[RESOLVED] Medicare Claim Process System Experiencing Outages We were experiencing outages with our IVR and NGSConnex claim status functionality. Technical support was engaged and the issue is now resolved. The IVR and NGSConnex claim status [...]
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Posting Date: 02/14/2025
MLN Connects® Newsletter: February 14, 2025
MLN Connects® Newsletter: February 14, 2025 News Complex Non-Chemotherapeutic Drug Administration: Determining Payment for Services Claims, Pricers, & Codes Ambulance Fee Schedule: CY 2025 Inflation Factor Integrated Outpatient [...]
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Posting Date: 08/25/2022
PA Exemption Tool Top
Prior Authorization Exemption Status Inquiry Tool This is a self-service tool to allow both hospital or physician office staff responsible for submitting PARs, to check the exempt status of the HOPD. This tool will only recognize the [...]
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Posting Date: 02/17/2025
Reminder: New Medicare Part B Redetermination Notice Initiative
Reminder: New Medicare Part B Redetermination Notice Initiative As we’ve communicated, National Government Services is transitioning to electronic notifications for Part B Medicare Redetermination decisions when a Medicare Part B [...]
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Posting Date: 02/17/2025
Collaborative Urological Supplies Webinar Coming 3/27/2025
Collaborative Urological Supplies Webinar Coming 3/27/2025 This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage of urological supplies. Representatives from all four [...]
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Posting Date: 11/12/2021
Requirements of Medicare Opt-Out Affidavit Agreement
Requirements of Medicare Opt-Out Affidavit Agreement Amendment 4507 of the Balanced Budget Act of 1997 permits a physician or practitioner to “opt out” of Medicare and enter into private contracts with Medicare beneficiaries if specific [...]
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Posting Date: 02/17/2025
Prepare and Submit an MSP Conditional Claim
Table of Contents Background Step 1: Determine if You Can Submit a Conditional Claim Step 2: Prepare a Conditional Claim Conditional Billing Code Table Step 3: Check for a Matching MSP Record for the Beneficiary in the Common [...]
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Posting Date: 02/26/2025
Accreditation of Advanced Diagnostic Imaging and FDA Mammography Equipment
Reminder, if a hospital, clinic/group or Independent Diagnostic Treatment Facility has ADI screening equipment, certification from a designated ADI accrediting organization needs to be implemented or updated on the Medicare enrollment. The [...]
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Posting Date: 07/05/2022
Audit and Reimbursement
Audit and Reimbursement Cost Report Filing State/Region Contact Information Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont JK_Cost_Report_Filing@anthem.com FQHC (All), [...]
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