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Posting Date: 05/17/2023
How to Prevent Common Skilled Nursing Facility Denials
How to Prevent Common Skilled Nursing Facility Denials This article was developed to increase awareness and educate SNFs on the top errors found by our Medical Review team. The information below includes suggestions to ensure documentation [...]
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Posting Date: 01/01/1970
ALOB_Mental Health Enrollment Reminders
Mental Health Enrollment Reminders Mental Health Enrollment Reminders Effective 1/1/2024, Medicare covers services furnished by MFTs and MHCs. Please note: The criteria listed below for mental health counselor includes clinical professional [...]
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Posting Date: 02/04/2022
Best Practices for a Successful Targeted Probe and Educate Review
Best Practices for a Successful Targeted Probe and Educate Review Table of Contents Getting Started With TPE Notification Letter During the Review Process Post-Probe/Review Results Letter Prepare for Post-Probe Education [Return to [...]
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Posting Date: 02/04/2022
Best Practices for a Successful Targeted Probe and Educate Review
Best Practices for a Successful Targeted Probe and Educate Review Table of Contents Getting Started With TPE Notification Letter During the Review Process Post-Probe/Review Results Letter Prepare for Post-Probe Education [Return to [...]
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Posting Date: 02/22/2022
Appeals Calculator Levels of Appeal Table
Five Levels of Appeals: Overview Levels Level One Level Two Level Three Level Four Level Five Type of Appeal Redetermination Reconsideration (QIC) Administrative Law Judge (ALJ) Medicare Appeals [...]
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Posting Date: 01/01/1970
AFH_How to Proactively Address Denials
How to Proactively Address Denials How to Proactively Address Denials Want to improve the Payment Error Rate for the next round of review? Be sure to learn about and understand claim denials before the end of round education with the Case [...]
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Posting Date: 10/04/2022
Daily Treatment Notes Requirement for Inpatient SNF Services
Therapy Treatment Note Requirement for Inpatient SNF Services The Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-2, Medicare Benefit Policy Manual, Chapter 15 is the primary source for therapy [...]
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Posting Date: 07/05/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 07/05/2022
Medical Review: Targeted Probe and Educate Review Topics
Medical Review: Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to [...]
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Posting Date: 02/09/2022
Targeted Probe and Educate Educational Videos
Targeted Probe and Educate Educational Videos Video Description Targeted Probe and Educate Learn more about the TPE Program. Additional educational information can be found on our Events page [...]
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Posting Date: 02/09/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 07/05/2022
Targeted Probe and Educate Review Topics
Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to supply medical [...]
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Posting Date: 06/03/2025
Home Health Billing Part One: The Notice of Admission
Provider Outreach and Education is hosting a two-part home health billing series. Part one will focus on what you need to know before billing, verifying eligibility, and the required fields to properly submit The Notice of Admission. This [...]
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Posting Date: 06/03/2025
Home Health Billing Part Two: The Period of Care Claim
Part two of this home health billing series focuses on the period of care claim, how reimbursement is determined under the Patient Driven Groupings Model, and review of the key billing requirements for claim billing. This session is a great [...]
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Posting Date: 06/04/2025
Complete a Voluntary Refund
Table of Contents Forms Used for Providers NOT on Automatic Immediate Recoupments and Check(s) Are Attached to This Form(s) Option 1: Completing the Voluntary Refund Form High Volume Spreadsheet Instructions Option 2: Large [...]
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Posting Date: 06/04/2025
Bankruptcy Notifications
Notify us if you file bankruptcy. If you have filed a bankruptcy petition or are involved in a bankruptcy proceeding, National Government Services requests that you notify us immediately so that we can properly coordinate with the CMS and the [...]
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Posting Date: 06/04/2025
How Should I Respond?
An overpayment may be identified and self-reported by a provider via clerfical error reopening or an overpayment, may be discovered by Medicare contractors as part of the claim and reimbursement review process. The key to reporting and repaying [...]
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Posting Date: 06/04/2025
Overpayment Request
Table of Contents Forms You'll Need Large Scale Overpayments Overpayment Notification Process Timeline for Processing a Demand Letter [Return to Top] Forms You'll Need Forms for non MSP-related are generally done via NGSConnex, but [...]
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Posting Date: 06/04/2025
Nettings/Offsets Across Organization Affiliations
Effective 1/4/2016, CMS implemented a change to begin netting/offsetting provider money across affiliated providers within the same and also across workloads within a single organization. This CMS change brings consistency to all Part B [...]
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