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  • Posting Date: 07/16/2025
    CO-109

    Avoiding/Correcting This Error This denial is received when your Medicare patient is enrolled in an MA plan, instead of “traditional fee-for-service” Medicare. MA plans are health plans offered by private companies approved by Medicare [...]

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  • Posting Date: 07/16/2025
    CO-16

    Avoiding/Correcting This Error Certain services require the name and NPI of the ordering or referring physician, depending on the service type. Definitions: Referring Physician: Requests an item or service for a Medicare beneficiary. [...]

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  • Posting Date: 07/16/2025
    PR-31

    Avoiding/Correcting This Error Services were denied for one or more of the following reasons: The name or Medicare number was incorrect or missing. The date of death precedes the date of service. Expenses were incurred prior to coverage. [...]

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  • Posting Date: 07/16/2025
    Care Coordination Services for FQHC/RHC Claims Improperly Paid

    Care coordination services for FQHC and RHC providers are being reimbursed incorrectly. According to CR 13581, they should be paid at the national nonfacility fee rate, but FISS is using the facility fee rate.

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