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Posting Date: 07/23/2024
Calculating the Batch Receipt Date
Calculating the Batch Receipt Date When a file is received in the EDI Gateway, the date and time received are applied as the receipt date of the claim(s). A business day is considered 12:00 a.m. to 4:59:59 p.m. ET Monday through Friday. [...]
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Posting Date: 01/29/2020
Minimum System Requirements and Support
Minimum System Requirements and Support PC Print is only compatible with officially supported Microsoft Windows Operating Systems. Please note that PC Print v4.2.6 is the only version compatible with Windows XP. PC Print software allows [...]
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Posting Date: 01/18/2022
Quarterly Top Ten Institutional EDI Edits
Quarterly Top Ten Institutional EDI Edits National Government Services EDI has identified the following top ten CEM edits that were received during Q1 2025 on the 277CA (Claims Acknowledgement) report for 837I 5010A1 formatted [...]
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Posting Date: 06/23/2025
Benefits of EDI
There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the [...]
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Posting Date: 01/29/2020
Benefits of Electronic Attachments
Benefits of Electronic Attachments The X12 275 Attachment transaction supports sending additional documentation electronically. Clinical documentation includes but not limited to; operative notes, consult notes, procedure notes, care plan, and [...]
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Posting Date: 03/16/2021
EDI Solutions J6
Helpful Resources EDI Front End Rejection Code Lookup Tool Reset My EDI Password Contact the EDI Help Desk 877-273-4334 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. CT * Closed for training on the [...]
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Posting Date: 06/18/2025
MLN Connects® Newsletter: June 18, 2025
MLN Connects® Newsletter: June 18, 2025 News 2023 Doctors & Clinicians Preview Period Open Until June 25 Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Medicare Part B Discarded Drug Program: Get [...]
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Posting Date: 10/15/2021
Home Health Referrals
Home Health Referrals Table of Contents Home Health Referrals Order for Home Health Services Documentation to Support Homebound Status Documentation to Support the Need for Skilled Services Documentation Regarding the Face-to-Face [...]
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Posting Date: 01/27/2015
Home Health Forms – Which is Required?
Home Health Forms – Which is Required? The Advance Beneficiary Notice/Home Health Change of Care Notice/Notice of Medicare Noncoverage Scenario ABN HHHCN NOMNC Patient met goals under the POC and is being [...]
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Posting Date: 06/07/2021
Eligibility Criteria for Face-to-Face Encounters
Eligibility Criteria for Face-to-Face Encounters National Government Services is reminding home health providers that a face-to-face encounter form is not adequate documentation to support that a face-to-face encounter occurred. [...]
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Posting Date: 02/08/2021
Wound Care Under the Medicare Home Health Benefit
Wound Care Under the Medicare Home Health Benefit Wound care treatment typically involves three skilled nursing interventions, which may be performed at the same time or separately from each other. The three services are: Performing the [...]
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Posting Date: 05/11/2020
Home Health Plans of Care: NPs, CNSs and PAs Allowed to Certify
Home Health Plans of Care: Nurse Practitioners, Clinical Nurse Specialists and Physician Assistants Allowed to Certify Section 3708 of the Coronavirus Aid, Relief, and Economic Security (CARES) Act (Pub. L. No. 116-136) amended sections [...]
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Posting Date: 11/30/2020
Homebound Status
Homebound Status A Medicare beneficiary must be confined to the home in order to use their Medicare home health benefit. CMS defines homebound status in the CMS IOM Publication 100-02, Medicare Benefit Policy [...]
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Posting Date: 04/12/2022
Home Health: The Definition of an Allowed Practitioner
Home Health: The Definition of an Allowed Practitioner As per MM12615 the “Definition of an Allowed Practitioner” has been revised to read as follows (CR 12615): Medicare Benefit Policy Manual Chapter 7 Section 30.2.1 – Definition of an [...]
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Posting Date: 05/02/2018
Filing an Electronic Notice of Cancelation (Type of Bill 8XD)
Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Table of Contents Filing an Electronic Notice of Cancelation (Type of Bill 8XD) Steps to Cancel a NOE Steps to Cancel a Benefit Period Submitting the 8XD Related Content [...]
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Posting Date: 09/30/2021
Filing an Electronic Notice of Transfer (Type of Bill 8XC)
Filing an Electronic Notice of Transfer (Type of Bill 8XC) Table of Contents Filing an Electronic Notice of Transfer (Type of Bill 8XC) Correcting the Transfer Date on a Previous Submitted Notice of Transfer Related Content [Return to [...]
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Posting Date: 12/19/2016
Hospice Site of Service Codes
Hospice Site of Service Codes Table of Contents Hospice Site of Service Codes HCPCS Codes Site of Service Location Notes Edits Related Content [Return to Top] Hospice Site of Service Codes Hospice agencies must report an HCPCS [...]
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Posting Date: 07/10/2017
The Medicare Hospice Benefit: Effects on Other Provider Types
The Medicare Hospice Benefit: Effects on Other Provider Types Table of Contents The Medicare Hospice Benefit: Effects on Other Provider Types What is Hospice Care Providing Services Related to the Terminal Condition Providing Services [...]
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Posting Date: 03/22/2017
Reporting Hospice Discharges, Revocations and Transfers
Reporting Hospice Discharges, Revocations and Transfers Medicare regulations at 42 CFR 418.26 outline three reasons for discharge from hospice care: The beneficiary moves out of the hospice’s service area or transfers to another [...]
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Posting Date: 11/09/2015
Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims
Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims Once a hospice chooses to admit a Medicare beneficiary, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises [...]
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