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Posting Date: 07/21/2022
Late Notice of Admission - The Exception Process
Late Notice of Admission - The Exception Process Table of Contents Timeliness of the NOA and the Penalty Requirements for Submission of the NOA Exception Process Canceling a Timely NOA to Correct an Error Reasons Not to Cancel an NOA [...]
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Posting Date: 05/09/2022
Home Health Transfers
Home Health Transfers Table of Contents Background What To Do As a Receiving HHA What To Do As the Initial HHA What To Do In Case of a Dispute Related Content [Return to Top] Background A home health transfer occurs when a [...]
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Posting Date: 12/05/2017
Disposable Negative Pressure Wound Therapy Services Under Home Health
Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]
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Posting Date: 05/09/2022
Home Health Agency Transfer and Dispute Protocol
Home Health Agency Transfer and Dispute Protocol Specific protocol and steps must be followed prior to opening an admission period for a new patient. Step One: Verify the patient’s eligibility You must ensure the patient is not [...]
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Posting Date: 12/20/2016
Reporting Site of Service Codes for Home Health Care
Reporting Site of Service Codes for Home Health Care HH PPS claim payments are based on the site of the beneficiary’s care. In order for Medicare to accurately capture where home health services are provided, HHAs are required to report the [...]
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Posting Date: 05/19/2022
Home Health Demand Billing
Home Health Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a Demand Bil Claim Page 1: Claim Page 2: Covered and Noncovered Charges Claim Page 2: All Noncovered Charges [...]
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Posting Date: 06/23/2025
Billing Telehealth Services for Part B Providers
During this webinar, we’ll provide you with insight into covered Medicare telehealth services and coverage requirements. We’ll discuss originating sites, distant sites and billing and payment guidelines.
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Posting Date: 07/12/2024
Hospice Transfers
Hospice Transfers The purpose of a hospice transfer is to allow the beneficiary the opportunity to transfer to another agency without affecting the current benefit period and providing continuity of care. Instead of the beneficiary revoking [...]
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Posting Date: 10/22/2015
Hospice Documentation Tips
Hospice Documentation Tips Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course. It is important that the [...]
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Posting Date: 10/05/2022
Tips for Responding to a Hospice ADR
Tips for Responding to a Hospice ADR National Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed. If one of your claims is [...]
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Posting Date: 10/04/2021
Implementation of the Election Statement Addendum
Implementation of the Election Statement Addendum Hospice Election Statement Addendum Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled to [...]
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Posting Date: 10/04/2021
Documentation Requirements for the Medicare Hospice Election Statement
Documentation Requirements for the Medicare Hospice Election Statement Election of Hospice Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled [...]
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Posting Date: 09/23/2015
Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims
Completing the Advance Beneficiary Notice of Noncoverage for Home Health Agency Demand Claims The purpose of the ABN is to appropriately notify a Medicare beneficiary of services that the HHA believes Medicare will not cover. In order for the [...]
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Posting Date: 12/16/2020
The Medicare Home Infusion Therapy Benefit and Home Health Agencies
The Medicare Home Infusion Therapy Benefit and Home Health Agencies If you are a HHA that wants to provide and bill Medicare HIT professional services starting in CY 2021, you are required to enroll with the Part B Medicare Administrative [...]
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Posting Date: 07/24/2017
Home Health Therapy Billing
Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]
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Posting Date: 09/09/2024
EDI Front End Clinical Edits
EDI Front End Clinical Edits EDI is continuing to implement EDI clinical business edits into the NGS EDI front end. These edits assist in proactively alerting providers of potential claim issues and provide resources to assist with avoiding [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]
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Posting Date: 08/13/2020
How to Get Started - Five Easy Steps
How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 275 transaction; HL7 CDA R2 [...]
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Posting Date: 08/10/2023
Duplicate Claim Editing Information
Duplicate Claim Editing Information National Government Services implemented a Part A duplicate claim edit in our EDI front-end processing system. Providers are notified that a claim is a duplicate upon receipt of the 277 Claims [...]
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Posting Date: 02/17/2022
How to Get Started
How to Get Started Making the change is easy. If you use a clearinghouse to submit claims, contact your clearinghouse to ask how to enroll for the electronic remittance service. If you currently have a claim submission software program, [...]
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