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Posting Date: 12/11/2024
Provisional Period of Enhanced Oversight for New Hospices
Provisional Period of Enhanced Oversight for New Hospices In recent years, CMS has reported a significant increase in fraudulent hospice billing practices, which cost the Medicare Program millions of dollars annually. The CMS has initiated a [...]
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Posting Date: 03/28/2016
Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement
Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement Table of Contents Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted [...]
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Posting Date: 12/21/2017
Hospice Billing Codes Chart
Hospice Billing Codes Chart Table of Contents Hospice Billing Codes Chart Condition Codes (CC) (UB-04 FL 18-28) Occurrence Codes (OC) and Dates (UB-04 FLs 31-34) Occurrence Span Code and Date (UB-04 FLs 35-36) Value Codes (VCs) and CBSA [...]
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Posting Date: 05/14/2018
Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77
Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Table of Contents Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77 Example of the Proper Use of OC 27 Example of the Proper Use of OC 27 with OSC 77 [...]
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Posting Date: 04/19/2018
Filing an Electronic Notice of Change of Ownership (TOB 8XE)
Filing an Electronic Notice of Change of Ownership (TOB 8XE) The Notice of Change of Ownership (TOB 8XE) is submitted when the hospice has a change of ownership that results in a change of the PTAN. Please refer to the Hospice Change of [...]
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Posting Date: 04/19/2018
Hospice Change of Ownership
Hospice Change of Ownership Table of Contents Hospice Change of Ownership What is Not a CHOW The Provider Enrollment Process Purchase Agreement Merger/Acquisition [Return to Top] Hospice Change of Ownership CHOW is defined [...]
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Posting Date: 06/20/2025
Annual Logon ID Recertification
All users who access the FISS DDE system are required by the CMS to recertify their access annually. National Government Services will designate one state at a time to complete the annual logon recertification. To complete the recertification [...]
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Posting Date: 06/20/2025
EDI Enrollment Process User Guide
This guide provides information on the different options available within the National Government Services EDI Enrollment Process User Guide. Please share your thoughts about your experience with our EDI Enrollment process. Reviewed [...]
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Posting Date: 06/20/2025
EDI Enrollment
Welcome This page is for providers who wish to submit Part A/B claims to Medicare. Once you have completed the initial provider enrollment and received your Welcome letter with Medicare, you can begin the EDI Enrollment process. Table of [...]
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Posting Date: 06/20/2025
HETS EDI Enrollment Form
HIPAA Eligibility Transaction System (HETS) allows users to exchange HIPAA compliant ANSI ASC X12 270/271 transactions for the purpose of checking Medicare eligibility. The HETS EDI Enrollment Form allows providers to attest their [...]
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Posting Date: 06/20/2025
Reset My FISS / DDE Password
CMS has directed it’s datacenters to enforce password requirements set forth in the United States Defense Information Systems Agency’s (DISA) Security Technical Implementation Guide (STIG) with regard to RACF password quality rules. The HPE VDC [...]
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Posting Date: 06/20/2025
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: 06/20/2025
I Am Not Yet Enrolled in Medicare
You can only begin set up with EDI if you are a participating provider in the Medicare program. If you have not submitted an application to enroll in Medicare, please visit our Enrollment section of the site for guidelines. If you have a [...]
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Posting Date: 06/20/2025
Trading Partner ID Recertification
All active trading partners are required to recertify their access annually. CMS requires any changes in demographic, contact information or access for a trading partner ID (TP ID) are communicated to the A/B MAC within 30 days of the change. [...]
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Posting Date: 07/19/2023
National Government Services Contractor Codes
National Government Services Contractor Codes The Contractor Code is a five-digit numeric code that indicates your MAC, also known as the Carrier Code, or Payer ID. Part B Professional: Connecticut 13102 Illinois 06102 Maine 14112 [...]
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Posting Date: 06/23/2025
Need Answers? The Options to Consider Before Calling or Writing Into Medicare
National Government Services self-service options and other channels can answer most of provider’s questions. During this session, we will show you how to effectively utilize these tools.
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Posting Date: 05/03/2024
About Prior Authorization
About Prior Authorization CMS has implemented Prior Authorization (PA) programs nationwide to ensure that Medicare beneficiaries continue to receive reasonable and necessary care while protecting the Medicare Trust Fund from improper payments. [...]
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Posting Date: 06/09/2021
About Hospital OPD PA Model
About Hospital OPD PA Model Table of Contents General Information Related Content [Return to Top] General Information Question Description WHO It is the responsibility of the hospital OPD to submit all [...]
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Posting Date: 06/14/2022
Documentation Information
Documentation Information It is recommended that PARs are submitted at least seven calendar days prior to the expected date of service to allow National Government Services (NGS) the full standard timeframe to receive and review requests. [...]
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Posting Date: 06/09/2021
OPD Facility/Physician Communication
OPD Facility/Physician Communication The implementation of the Outpatient Department (OPD) Prior Authorization (PA) program has specific implications for Part B physicians performing services within hospital OPDs. Each prior authorization [...]
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