Search Results - NGSMEDICARE

Posting Date: 04/24/2025

NGSConnex Part B Claim Submissions and Claim Status Inquiry

Submitting Medicare Part B claims can be simple and efficient through the NGSConnex portal. During this webinar, we’ll show you how. We’ll review claim information including how to initiate a Part B claim, how to use the copy claim feature, [...]

Posting Date: 04/24/2025

NGSConnex: Claims and Medical Review Additional Documentation Requests

In NGSConnex, you have the ability to check the status of claims that have been selected for claim or medical review additional documentation requests (ADRs) in the last forty-five days for the provider selected. The ADR summary will show if [...]

Posting Date: 10/19/2022

Clinical Trials

Clinical Trials Clinical trials are interventional studies that assess treatments or diagnostics compromising experimental and control groups. Medicare coverage in these trials is guided by strict CMS rules and is limited to FDA-approved [...]

Posting Date: 04/23/2025

Understanding the Reopening and Appeal Process Open Forum

National Government Services is committed to reducing provider burden associated with Medicare claim denials, reopenings and appeals. Filing an inquiry on a Medicare claim can be frustrating and costly to your organization. This delay in [...]

Posting Date: 04/23/2025

55H2B

Avoiding/Correcting This Error Ensure the submitted documentation supports the beneficiary is confined to the home. An individual shall be considered “confined to the home” (homebound) if the following two criteria are met: [...]

Posting Date: 04/23/2025

31287

Avoiding/Correcting This Error Hospice claims are required to be billed monthly. Verify the month beginning and ending date and the ‘From’ and ‘To’ dates on your claim. The claim must span the entire month for continuing care claims.

Posting Date: 04/23/2025

30993

Verify the MBI submitted on the claim matches the MBI in the Common Working File. If a new MBI has been assigned, follow the guidelines regarding the claim submission: For dates of service before the MBI change date use old or new MBI If [...]

Posting Date: 04/23/2025

37236

Avoiding/Correcting This Error Verify eligibility of the attending/ordering physicians in PECOS. Print that verification and make it part of the medical record. If applicable, submit a reopen request to the Appeals Department indicating error [...]

Posting Date: 04/23/2025

55HTP

Avoiding/Correcting This Error Verify that the initial certification is complete and includes all necessary elements, such as the patient’s homebound status, the need for skilled services, and a face-to-face encounter with a physician or [...]

Posting Date: 04/23/2025

55H1L

Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]