How to Avoid Duplicate Claims

Duplicate denials continue to be one of the top billing errors. Unnecessary duplicate filing of Medicare claims cost the provider's office valuable time and resources, as well as Medicare's time and money to process them. Please join us [...]

Utilizing Third Party Billing Companies

Medicare providers frequently outsource their billing, financial, and enrollment services. During this webinar, we’ll highlight the need to contract with Centers for Medicare & Medicaid Services (CMS)-approved entities and ensure these [...]

Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

ADR Documentation List by Reason Code

How to Find and Respond to a Prior Authorization ADR Table of Contents How to Find and Respond to a PA Pre and Post Payment ADR Steps to View and Print ADRs from FISS/DDE Provider Online System Related Content [Return to Top] How to [...]

Exemption Process

Exemption Table of Contents Exemption Exemption Database Standard Review Cycle Process Exemption Cycle Process Ten Claim Sample Additional Documentation Requests (ADRs) How to Find and Respond to a Prior Authorization ADR Related [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the Centers for Medicare & Medicaid Services (CMS)-1500 [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the Centers for Medicare & Medicaid Services (CMS)-1500 [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

MLN Connects® Newsletter: July 10, 2025

MLN Connects® Newsletter: July 10, 2025 News Hospital Price Transparency: Respond to Accuracy & Completeness RFI by July 21 Alert: Medicare Fraud Scheme Involving Phishing Requests Via Fax and Other Means Transcatheter Edge-to-Edge [...]

Phonetic Alphabet

table, td, th table { border-collapse: collapse; width: 50%; } Phonetic Alphabet To assist you when speaking terms that are alpha-numeric, we've implemented the phonetic alphabet. When speaking an alpha character, please use the [...]

Phonetic Alphabet

table, td, th table { border-collapse: collapse; width: 50%; } Phonetic Alphabet To assist you when speaking terms that are alpha-numeric, we've implemented the phonetic alphabet. When speaking an alpha character, please use the either [...]

The Medicare Appeals Process: What You Need to Know

This informative session will help you navigate Medicare’s appeals process by providing information on what an appeal is, how to determine if a claim can be appealed, who may file an appeal, the appeal levels, timeframes and documentation [...]

Principal Care Management

Principal Care Management PCM is a model of care focused on patients with a single, high-risk chronic condition expected to last 6 months to 1 year or until the patient’s death and designed to improve health outcomes and reduce complications. [...]

IMPORTANT: Action Required for SNF Due Date of 8/1/2025

IMPORTANT: Action Required for SNF Due Date of 8/1/2025 For those SNFs that have not yet submitted their Form CMS-855A revalidation application or, as applicable, SNF Attachment, this is an important reminder that you must do so by [...]

LCD and Billing and Coding Articles Updates

LCD and Billing and Coding Articles Updates Local Coverage Determinations Drugs and Biologicals, Coverage of, for Label and Off-Label Uses (L33394) This LCD was released to Final on 5/29/2025 and will be effective 7/13/2025. The Indications [...]

Chiropractic Billing and Documentation

During this webinar, we will discuss chiropractic coverage, coding guidelines and the importance of documentation in order to support billing for these services.

Fast Track Access

Fast Track Access You will be prompted for the fast-track access when you use a feature that requires provider authentication (NPI, PTAN, TIN). Features: Claim Status, Checks, Offsets, Pricing, Appeals You can obtain a code after you [...]

General Information <8>

General Information <8> When General Information is selected, the IVR will present the caller with a submenu. Voice Touch-Tone Entry IVR Supplies Phone Numbers 1 Commonly requested telephone numbers [...]

Using Touch-Tone

Using Touch-Tone The IVR is programmed to allow for the entry of all data using touch‐tone in the event the user is unable to successfully speak to the IVR. These instructions detail how to use touch‐tone to enter various types of information [...]

Using Touch-Tone

Using Touch-Tone Table of Contents Using Touch-Tone Using Touch-Tone for Alpha-Numeric Elements Using Touch-Tone to Enter a Letter [Return to Top] Using Touch-Tone The IVR is programmed to allow for the entry of all data [...]

Interactive Voice Response Touch-Tone Instructions

Interactive Voice Response Touch-Tone Instructions Alpha-Numeric Touch-Tone Entries Use this function to enter elements that contain both alpha and numeric characters. Each button on a telephone keypad has a corresponding set of letters. Each [...]

Main Menu Options

Main Menu Options The main menu and subsequent menus can be navigated by using your voice or using touch‐tone on your telephone keypad. You can also use touch‐tone entry for provider numbers, Medicare numbers, PTAN, NPI, TIN, dates of service, [...]

Interactive Voice Response System Changes Coming Soon

Interactive Voice Response System Changes Coming Soon We’re making changes to our IVR system soon. You’ll still dial the same number, but you’ll hear a new voice. If the IVR doesn't recognize your voice, we recommend you switch to touch tone. [...]

When billing for waste on a single use vial would you round units up or down for a half unit?

J3357, Ustekinumab (Stelara) is listed on the Self-Administered Drug Exclusion List: Medical Policy Article A53021, and it says “acceptable”. Does this mean it is excluded or not?

If using steroid during diagnostic is that when the 12-month clock start?

What is the proper way to submit professional physician claim with multiple NDC numbers for the same drug code?

When billing an unclassified drug code such as J3490, are the units of service on the claim always equal to one?

What is the correct way to bill an unlisted drug or biological?

How do I bill a bilateral joint injection and HCPCS J1040 for two units?

Does Medicare Part B make payment for the unused portion of a multi-dose vial of a drug/biological?

Is the shingles vaccine covered by Medicare?

Why is radiofrequency ablation (RFA) noncovered?

Is the GY modifier required on the drug code and the administration code for noncovered self-administered drugs?

Does the waste with the JW modifier appended always go on the second line regardless of the billed amount? For example, the billed amount for the waste is higher than the administered amount.