Search Results - NGSMEDICARE

Posting Date: 12/20/2016

Reporting Site of Service Codes for Home Health Care

Reporting Site of Service Codes for Home Health Care HH PPS claim payments are based on the site of the beneficiary’s care. In order for Medicare to accurately capture where home health services are provided, HHAs are required to report the [...]

Posting Date: 04/11/2017

Billing G-Codes for Therapy and Skilled Nursing Services

Billing G-Codes for Therapy and Skilled Nursing Services Table of Contents Billing G-Codes for Therapy and Skilled Nursing Services What You Need to Know to Bill Physical Therapy Occupational Therapy Speech Language Pathology [...]

Posting Date: 09/23/2015

Completing the Advance Beneficiary Notice for Home Health Agency Demand Claims

Completing the Advance Beneficiary Notice of Noncoverage for Home Health Agency Demand Claims The purpose of the ABN is to appropriately notify a Medicare beneficiary of services that the HHA believes Medicare will not cover. In order for the [...]

Posting Date: 02/04/2022

Notice of Admission Questions and Answers

Notice of Admission Questions and Answers Medicare requires HHAs to submit a one-time NOA instead of RAPs for new admissions starting on or after 1/1/2022. HHAs shall no longer submit RAPs, TOB 0322 for any HH periods of care with a “From” [...]

Posting Date: 12/16/2020

The Medicare Home Infusion Therapy Benefit and Home Health Agencies

The Medicare Home Infusion Therapy Benefit and Home Health Agencies If you are a HHA that wants to provide and bill Medicare HIT professional services starting in CY 2021, you are required to enroll with the Part B Medicare Administrative [...]

Posting Date: 07/24/2017

Home Health Therapy Billing

Home Health Therapy Billing Table of Contents Home Health Therapy Billing 32X TOB: Billing Therapy Under a Home Health Plan of Care Discipline Revenue Codes (UB-04 FLs 42-43) Discipline HCPCS Codes (UB-04 FL 44) Service Units [...]

Posting Date: 09/09/2024

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 [...]

Posting Date: 08/13/2020

How to Get Started - Five Easy Steps

How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 275 transaction; HL7 CDA R2 [...]

Posting Date: 07/09/2020

Participating Clearinghouses and Vendors

Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]

Posting Date: 03/01/2022

Benefits of Electronic Remittance Advice

Benefits of Electronic Remittance Advice Table of Contents Benefits of Electronic Remittance Advice There Are Several Benefits to Choosing ERA Versus SPR Help Interpreting the ERA Is Available [Return to Top] Benefits of Electronic [...]

Posting Date: 08/10/2023

Duplicate Claim Editing Information

Duplicate Claim Editing Information National Government Services implemented a Part A duplicate claim edit in our EDI front-end processing system. Providers are notified that a claim is a duplicate upon receipt of the 277 Claims [...]

Posting Date: 02/17/2022

How to Get Started

How to Get Started Making the change is easy. If you use a clearinghouse to submit claims, contact your clearinghouse to ask how to enroll for the electronic remittance service. If you currently have a claim submission software program, [...]

Posting Date: 03/08/2021

Benefits of the 277 RFI

Benefits of the 277 RFI The X12 277 RFI transaction replaces the paper Additional Development Request letters. The 277RFI transaction is available for JK/J6 Part A and Part B providers. The benefits of the 277RFI transaction include: [...]

Posting Date: 04/20/2020

Participating Clearinghouses and Vendors

Participating Clearinghouses and Vendors The following entities support electronic attachments with NGS. Any of these entities can assist you with implementing electronic attachments and participating in the NGS Attachment Program. [...]

Posting Date: 09/19/2022

Changing Your EDI Password

Changing Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to change your [...]

Posting Date: 08/13/2020

How To Get Started - Five Easy Steps

How To Get Started – Five Easy Steps Contact your vendor, clearinghouse or billing service to ensure they support the electronic attachment program which includes the following: 6020 version of the 277RFI transaction; HL7 CDA R2 [...]

Posting Date: 09/19/2022

Resetting Your EDI Password

Resetting Your EDI Password EDI passwords have to be regularly changed or reset to maintain data security. You should note that passwords expire every 60 days and can be changed or reset prior to expiration. Follow these steps to reset your [...]

Posting Date: 09/19/2022

Password Reset Requirements Checklist

Password Reset Requirements Checklist The following information will assist you in successfully resetting your password and eliminate any unnecessary disconnects. You should note that passwords expire every 60 days and can be reset prior to [...]

Posting Date: 09/28/2022

EDI Gateway Self-Service Password Portal Overview

EDI Gateway Self-Service Password Portal Overview Table of Contents EDI Gateway Self-Service Password Portal Overview Changing versus Resetting Your Password Changing Your Password Resetting Your Password EDI Gateway Self-Service [...]

Posting Date: 09/19/2022

Setting Your Security Questions

Setting Your Security Questions Setting up Security Questions is part of the required process for establishing an EDI Gateway Self-Service Portal account. Follow these steps to set up your account Security Questions. Access the Trading [...]

Posting Date: 01/29/2020

Key Features

Key Features PC-ACE is a comprehensive claims management system. Some of the more prominent features include: Combined Medicare Part A, Institutional All-Payer and Professional claims system Electronic submission of claims in ANSI-837 [...]

Posting Date: 11/17/2020

Download PC-ACE

Download PC-ACE Download PC-ACE If you intend to administer the COVID-19 vaccines when they become available, or the new monoclonal antibody bamlanivimab, especially if you intend to roster bill these codes, please download and install the [...]

Posting Date: 01/29/2020

Minimum System Requirements and Support

Minimum System Requirements and Support Minimum System Requirements SVGA monitor resolution (800 x 600) Windows 10, Windows 8.1, Windows 7 or Vista operating system Adobe Acrobat Reader Version 4.0 or later (for overlaid claim printing) [...]

Posting Date: 06/22/2022

PC-ACE Software Instructions, Resources and Guides

PC-ACE Software Instructions, Resources and Guides Creating a 276 Claim Status Request in PC-ACE and Importing and Reading the 277 Claim Status Report PC-ACE - For Institutional Users: Importing and Reading the 999 and 277CA Files PC-ACE [...]

Posting Date: 01/29/2020

About PC Print

About PC Print The PC Print software is available for providers to view and print HIPAA-compliant ERAs from their own computer. The PC Print software is available to you at no cost. This software is easy to use and will save you both time and [...]

Posting Date: 01/29/2020

Minimum System Requirements and Support

Minimum System Requirements and Support PC Print is only compatible with officially supported Microsoft Windows Operating Systems. Please note that PC Print v4.2.6 is the only version compatible with Windows XP. PC Print software allows [...]

Posting Date: 11/16/2021

Technical Guides and Information

Technical Guides and Information 5010 Process Flow Chart X12 Website: Technical Reports/Implementation Guides, Newsletters and X12 Transaction Sets Reviewed 6/23/2025

Posting Date: 06/03/2022

Network Service Vendors

Network Service Vendors National Government Services requires connectivity to the EDI Gateway for exchange of EDI data through select NSVs. In addition to connectivity to the EDI Gateway for the exchange of HIPPAA transactions, these vendors [...]

Posting Date: 07/23/2024

Calculating the Batch Receipt Date

Calculating the Batch Receipt Date When a file is received in the EDI Gateway, the date and time received are applied as the receipt date of the claim(s). A business day is considered 12:00 a.m. to 4:59:59 p.m. ET Monday through Friday. [...]

Posting Date: 06/23/2025

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 [...]

Posting Date: 01/29/2020

Benefits of Electronic Attachments

Benefits of Electronic Attachments The X12 275 Attachment transaction supports sending additional documentation electronically. Clinical documentation includes but not limited to; operative notes, consult notes, procedure notes, care plan, and [...]

Posting Date: 01/29/2020

EDI and How it Works

EDI and How it Works EDI is an electronic communication method that enables fast, accurate and reliable exchange of data between the computer systems of organizations that do business together by using the same standardized message formatting, [...]

Posting Date: 03/16/2021

EDI Solutions JK

Helpful Resources EDI Front End Rejection Code Lookup Tool Reset My EDI Password Contact the EDI Help Desk 888-379-9132 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. CT * Closed for training on the [...]

Posting Date: 10/01/2024

New Version of PC-ACE: January 2025

New Version of PC-ACE: January 2025 PC-ACE Version 6.5 contains several CMS mandates and product enhancements including but not limited to the items listed below. Change Request (CR) 13794 - Combined Common Edits/Enhancements Modules [...]

Posting Date: 03/16/2021

EDI Solutions J6

Helpful Resources EDI Front End Rejection Code Lookup Tool Reset My EDI Password Contact the EDI Help Desk 877-273-4334 Available by phone or email Monday–Friday* 8:00 a.m.–5:00 p.m. ET 7:00 a.m.–4:00 p.m. CT * Closed for training on the [...]

Posting Date: 01/29/2020

Key Features

Key Features PC Print offers several different report displays and the ability to print the reports as needed. The Single Claim Report includes the activity at the claim and detail line items for a single claim. The All Claims Report [...]

Posting Date: 01/18/2022

Quarterly Top Ten Institutional EDI Edits

Quarterly Top Ten Institutional EDI Edits National Government Services EDI has identified the following top ten CEM edits that were received during Q1 2025 on the 277CA (Claims Acknowledgement) report for 837I 5010A1 formatted [...]

Posting Date: 07/01/2024

17729 and 17730 Hospice Claim Edits for Certifying Physicians

17729 and 17730 Hospice Claim Edits for Certifying Physicians Effective for hospice claims with claim ‘From’ dates on or after 6/3/2024, new claim edits have been implemented per CR 13342 to enforce CMS’ rule to deny hospice claims if the name [...]

Posting Date: 07/17/2024

Billing Hospice Transfers

Billing Hospice Transfers Once a beneficiary elects to receive care under the Medicare hospice benefit, he or she waives rights to Medicare payments for hospice care provided by any other hospice other than the one they have chosen/designated. [...]