APPROVAL RECOMMENDATION STATUS: The status of my application is approval recommendation, how can I verify if the state agency or CMS has completed their process?

Medicare Part B Drugs and Biologicals

Medicare Part B covers certain drugs and biologicals, which require specific billing guidelines. During this webinar, we’ll assist NGS Part B providers in navigating proper billing for these services. There will be time following the [...]

Lets Chat about Federally Qualified Health Center Billing and Reimbursement

Need answers on FQHC billing and reimbursement without attending a full training? Join our 30-minute "Let's Chat" session. This informal discussion allows providers to engage with our Provider Outreach and Education team. You are [...]

NGSConnex: Appeals, Clerical Error Reopening and Prior Authorization Request

This webinar is geared toward Part B providers who bill to Medicare on a CMS-1500 form. Did you ever wonder what you need to do when a claim denies, or you might have made a clerical error on a claim? What about checking on prior authorization? [...]

Medicare Part B Top 10 Claim Denials

Each quarter, we host this webinar to address the top claim denials we receive. We research and identify common errors and offer solutions to prevent them, which has effectively reduced errors. There will be time following the presentation to [...]

CERT Awareness Week Four – We Appreciate Your Efforts

CERT Awareness Week Four – We Appreciate Your Efforts The Part A, Part B, DME, home health and hospice, and Railroad Board MACs are working together to promote the importance of complying with CERT documentation requests. This is the final in [...]

Prolonged Services

Prolonged Services Note: View the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 30.6.15.2 and Section 30.6.15.3 for CPT codes [...]

Submit Medicare Secondary Payer Claims Correctly the First Time!

Submit Medicare Secondary Payer Claims Correctly the First Time! If you're facing challenges related to MSP claim submissions for Medicare Part B, then this information is important for you. Ensuring that claims are submitted correctly the [...]

Provider Enrollment: Opioid Treatment Program

During this webinar, we’ll provide a brief overview of an Opioid Treatment Program (OTP) provider, an understanding of submitting the CMS-855A or CMS-855B paper application and how to complete the provider enrollment Internet-based Provider [...]

Method II CAH Claims Not Paying Professional Services with Revenue Codes 096x-098x

Certain CAH claims (TOB 85X) with professional service revenue codes 096x – 098X did not process for payment because the fee amount was not correctly retrieved during processing. The affected claims have receipt/processed dates in October 2024.

View our Educational Frequently Asked Questions

View our Educational Frequently Asked Questions Our educational FAQs have been reviewed and updated. Please visit the Help and FAQs page under the Education section of our website to explore topics such as: ASCA Appeals CAR T-cell Therapy [...]

Part A Ambulance Transport: Understanding the Basics

The purpose of this presentation is to give Medicare Part A Ambulance providers a better understanding of who is responsible to report services to Medicare.

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 [...]

55H20

Avoiding/Correcting This Error This denial is based on review of a claim that was submitted as a demand bill. The charges on this claim are beneficiary liable. The beneficiary may be billed for these charges.