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Posting Date: 11/14/2024
MLN Connects® Newsletter: November 14, 2024
MLN Connects® Newsletter: November 14, 2024 News 2025 Medicare Parts A & B Premiums and Deductibles Medicare Participation for CY 2025 Ambulance Fee Schedule: CY 2025 Final Policies Prior Authorization Review Timeframe Change [...]
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Posting Date: 11/14/2024
November 21st is The Great American Smokeout
November 21st is The Great American Smokeout You Can Help Your Patients Quit Smoking Smoking is one of the leading causes of heart disease and stroke. At least 70% of cigarette smokers see a clinician annually and many want to quit. Each [...]
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Posting Date: 11/14/2024
Part B Claims Denied with Error 524B
An error in CWF processing has not yet been fully corrected. The error is occurring when Demo Codes A5 (Making Care Primary-MCP) or A6 (Guiding an Improved Dementia Experience-GUIDE) are on the claim and the HIC on the claim has an active MSP [...]
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Posting Date: 05/05/2021
IVR Conversion Table
Conversion Chart for Patient Names Conversion Chart for Beneficiary HICN/MBI/PTAN/DCN Letter Conversion Letter Conversion A 2 A *21 B 2 B *22 C 2 C *23 [...]
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Posting Date: 11/14/2024
Using the IVR
Table of Contents MBI Phonetic Alphabet Now Available Tips MBI Phonetic Alphabet IVR Conversion Tool [Return to Top] MBI Phonetic Alphabet Now Available To assist you when speaking the MBI, we have implemented the MBI phonetic [...]
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Posting Date: 06/23/2021
When to Use the Provider Contact Center Versus Self-Service Tools
When to Use the Provider Contact Center Versus Self-Service Tools The CMS requires contractors to provide self-service and electronic communication technologies as efficient, cost effective means of disseminating Medicare provider information, [...]
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Posting Date: 11/08/2019
Prothrombin Time
Prothrombin Time We have experienced an increasing number of CERT errors due to documentation requirements not being met. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper [...]
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Posting Date: 10/15/2019
Diagnostic Mammography
Diagnostic Mammography Insufficient Documentation Causes Most Improper Payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 09/20/2019
Prolonged Services
Prolonged Services Insufficient documentation causes most improper payments. Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was [...]
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Posting Date: 06/27/2019
Annual Wellness Visit
Annual Wellness Visit Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for an [...]
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Posting Date: 01/29/2021
Hyperbaric Oxygen Therapy Treatment
Hyperbaric Oxygen Therapy Treatment Insufficient documentation is documentation that was incomplete, inaccurate or was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient [...]
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Posting Date: 01/29/2021
Surgery Services
Surgery Services Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Medication Administration
Medication Administration Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Ambulance Services
Ambulance Services Insufficient documentation means that something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Stereotactic Body Radiation Therapy
Stereotactic Body Radiation Therapy Insufficient documentation means that something was missing from the medical records. Below are the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Anesthesia Services
Anesthesia Services Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Diagnostic Testing Services
Diagnostic Testing Services Insufficient documentation means something was missing from the medical records. Below is a list of the most common reasons CERT determined there was insufficient documentation that caused improper payments for [...]
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Posting Date: 01/29/2021
Transcatheter Aortic Valve Replacement
Transcatheter Aortic Valve Replacement The CMS CERT program produces a national Medicare FFS error rate, as required by the Improper Payments Information Act. CMS strives to eliminate improper payments in the Medicare Program to maintain the [...]
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Posting Date: 01/29/2021
Part A to Part B Claims (Rebilling) Submissions
Submitting Part A to Part B Claims (Rebilling) Submissions Administrator’s Ruling CMS 1455-R The Administrator’s Ruling CMS 1455-R, issued on 3/13/2013 established an interim process for hospitals to use to submit claims for Part B [...]
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Posting Date: 01/29/2021
Inpatient Hospital Surgery
Inpatient Hospital Surgery National Government Services would like to alert providers on one of the highest dollar and most avoidable denials from the CERT contractor: submitting documentation relating to inpatient hospital surgeries. [...]
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