CO-16

Avoiding/Correcting This Error Certain services require the name and NPI of the ordering or referring physician, depending on the service type. Definitions:  Referring physician: Requests an item or service for a Medicare beneficiary. [...]

CO-16

Avoiding/Correcting This Error The MBI is necessary for all claims submitted to MAC. Claims without a correct MBI are rejected, requiring providers to verify and resubmit them. To avoid this, use the Eligibility Lookup in NGSConnex before [...]

CO-16

Avoiding/Correcting This Error This rejection is the result of submitting a CPT/HCPCS code without a required modifier. You are required to research the proper modifier to report with the CPT/HCPCS code then submit a new claim. Please use [...]

OA-18

Avoiding/Correcting This Error A duplicate claim submission occurs when a provider resubmits a claim either on paper or electronically for a single encounter and the service is provided by the same provider to the: same beneficiary; for the [...]

CO-22

Avoiding/Correcting This Error During patient registration it’s important for office staff to identify whether a beneficiary’s claims should be covered by other insurance before, or in addition to, Medicare. Providers shall use [...]

CMS FQHC Booklet

Colorectal Cancer Screening

Preventive Services Guide Colorectal Cancer Screening Screenings are performed to diagnose colorectal cancer or to determine a beneficiary’s risk for developing colorectal cancer. Colorectal cancer screening may consist of several different [...]

Rural Health Clinic Billing Basics

This webinar will provide a detailed overview of the Medicare billing requirements for rural health clinics (RHC), including the definition of a qualifying visit, locations where billable RHC services can occur, claim coding guidelines and [...]

A/B and DME Collaborative YouTube Video

A/B and DME Collaborative YouTube Video The A/B DME MACs are offering a YouTube video on Urological Supplies. This DME video tutorial provides information about urological supply requirements. Posted 5/7/2025  

Provider Contact Center – Make the Most of Your Call

Provider Contact Center – Make the Most of Your Call As of 5/1/2025, the Provider Contact Center (PCC) will service one PTAN/NPI combination per call. Before calling the PCC, make the most of your call by ensuring you have all authentication [...]