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Posting Date: 04/21/2021
Appeals/Reopenings
Medicare Part B 101 Manual Appeals/Reopenings Table of contents Reopenings for Minor Errors and Omissions Telephone Reopening Unit Appeals Time Limit for Filing Appointment of Representative Redeterminations Acceptable Signature [...]
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Posting Date: 10/07/2021
CMS-1500 Claim Form
Medicare Part B 101 Manual CMS-1500 Claim Form Table of Contents General Information Claim Filing Instructions for Paper and Electronic Submission Regulations on Charging for Claim Form Completion OCR System Missing, Incomplete, [...]
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Posting Date: 10/28/2022
Comprehensive Error Rate Testing
Medicare Part B 101 Manual Comprehensive Error Rate Testing Table of Contents Comprehensive Error Rate Testing What Is CERT? How Long Do Providers Have to Respond to a Request From the CERT Contractor? What Happens if the Provider [...]
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Posting Date: 04/08/2021
Fraud and Abuse
Medicare Part B 101 Manual Fraud and Abuse Fraud and Abuse Unified Program Integrity Contractors Defining Fraud and Abuse Fraud Abuse Bribes, Kickbacks and Rebates Penalties Waiving Deductible and Coinsurance What You Can Do As a [...]
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Posting Date: 10/06/2021
Medical Policy Development
Medicare Part B 101 Manual Medical Policy Development Table of Contents Medical Policy Development National Policies National Coverage Determinations National Coverage Provisions in Interpretive Manuals Local Policies [...]
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Posting Date: 10/12/2018
Help with Medicare Costs
Help with Medicare Costs Medicare Savings Programs Learn about your options for help with Part B premiums Costs for Medicare Drug Coverage Learn how to get extra help with Part D Revised 11/1/2024
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Posting Date: 10/29/2024
Don’t Wait Until 11/18/2024 To Use NGSConnex for Beneficiary Eligibility Information
Don’t Wait Until 11/18/2024 To Use NGSConnex for Beneficiary Eligibility Information As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary [...]
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Posting Date: 10/31/2024
Report a Change of Tax ID (Other than Change of Ownership)
Step 1: Determine You are in the Right Place If you are currently an enrolled health care organization that is changing your Tax ID and the change does not involve a change of ownership, it is essential that you report changes of Tax ID within [...]
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Posting Date: 10/31/2024
Report a Change of Tax ID (Other than Change of Ownership)
Step 1: Determine You are in the Right Place If you are currently an enrolled health care organization that is changing your Tax ID and the change does not involve a change of ownership, it is essential that you report changes of Tax ID within [...]
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Posting Date: 10/31/2024
Report a Change of Tax ID (Other than Change of Ownership)
Table of Contents Step 1: Determine You are in the Right Place Step 2: Complete the Medicare Application Step 3: Submit Required Documentation Related Content [Return to Top] Step 1: Determine You are in the Right Place If you are [...]
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Posting Date: 09/24/2019
Mission and Charter
National Government Services Provider Outreach and Education Advisory Group Charter National Government Services serves as the MAC for J6 and JK Part A, Part B and Home Health and Hospice. We maintain four POE AGs: Part A POE [...]
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Posting Date: 10/19/2022
Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service
Medicare Part B Electronic Claims that Exceed the Threshold for Charges and Units of Service Medicare Part B electronic claims (ANSI X12 837P) with total charges exceeding $99,999.99 cannot be processed in the MCS. If a single claim [...]
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Posting Date: 10/31/2024
MLN Connects® Newsletter: October 31, 2024
MLN Connects® Newsletter: October 31, 2024 News Medicare Shared Savings Program Continues to Deliver Meaningful Savings and High-Quality Health Care Compliance Major Hip & Knee Replacement or Reattachment of Lower Extremity: [...]
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Posting Date: 11/05/2024
Report a Change of Ownership, Acquisition/Merger or Consolidation
Table of Contents Step 1: Determine You Are in the Right Place Step 2: Understand Type of CHOW Change of Ownership Acquisition/Merger Consolidation CHOW Reminders Step 3: Make Changes via Enrollment Application Change of [...]
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Posting Date: 11/04/2024
Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information
Two Weeks to Prepare to use NGSConnex for Beneficiary Eligibility Information As we’ve communicated, beginning 11/18/2024, Beneficiary Eligibility information will not be offered on the IVR. This includes all beneficiary eligibility [...]
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Posting Date: 11/01/2024
Instructions for Unfinished PECOS Enrollment Application(s)
Table of Contents Instructions for Unfinished PECOS Enrollment Application(s) Instructions for Unfinished PECOS Application(s) Instructions for Application Status “Pending E-Signature” Submitted Enrollment Application(s) on Behalf of an [...]
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Posting Date: 11/05/2024
Report a Change of Information
Report change of enrollment information timely. Changes can be either submitted electronically via PECOS or by mail with the paper CMS-855A and/or CMS-588 EFT agreement. A change in the Tax ID with no ownership change will need to submit [...]
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Posting Date: 11/05/2024
Report a Change of Information
Report change of enrollment information timely. Changes can be either submitted electronically via PECOS or by mail with the paper CMS-855A and/or CMS-588 EFT agreement. A change in the Tax ID with no ownership change will need to submit [...]
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Posting Date: 11/05/2024
Report a Change of Information
Table of Contents Report a Change of Information PECOS Submission Related Content Paper Submission Related Content [Return to Top] Report a Change of Information Report change of enrollment information [...]
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