Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K Part A Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Debridement, subcutaneous tissue (includes epidermis and dermis, if performed) 11042, 11045 [...]

About Appeals

About Appeals Table of Contents About Appeals Reopening vs. Redetermination Reopening Redetermination [Return to Top] About Appeals Providers and beneficiaries have the right to appeal claim determinations made by National [...]

REMITTANCE: What do the two-letter codes on my remittance advice mean?

PC-ACE: Where can I find out more about the PC-ACE free billing software?

PC-ACE: Why did my PC-ACE software expire?

Provider Enrollment

Medicare Part B 101 Manual Provider Enrollment Table of Contents National Provider Identifier Required Tips for Successfully Enrolling with the Medicare Part B Contractor When Mailing Paper Applications Tip 1: Submit the correct [...]

CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications

CMS Is Using Multi-Factor Authentication Process for Online Provider Enrollment System Applications CMS announced they utilize an MFA process for users of their Provider Enrollment Systems.  MFA is a second layer of security used to [...]

National Government Services Medicare Part B Redetermination Notice Initiative Is Here

National Government Services Medicare Part B Redetermination Notice Initiative Is Here As previously announced, National Government Services is pleased to announce we are discontinuing issuing paper MRNs for requests submitted electronically [...]

Credentialing, Enrollment and Revalidation

Credentialing, Enrollment and Revalidation Table of Contents Requirements Facilities that are not qualified Qualifications Application Forms You Will Need Required Application Fee Documentation State Survey, Tie-in Notice [...]