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Posting Date: 06/04/2025
Bankruptcy Notifications
Notify us if you file bankruptcy. If you have filed a bankruptcy petition or are involved in a bankruptcy proceeding, National Government Services requests that you notify us immediately so that we can properly coordinate with the CMS and the [...]
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Posting Date: 06/04/2025
How Should I Respond?
An overpayment may be identified and self-reported by a provider via clerfical error reopening or an overpayment, may be discovered by Medicare contractors as part of the claim and reimbursement review process. The key to reporting and repaying [...]
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Posting Date: 06/04/2025
Overpayment Request
Table of Contents Forms You'll Need Large Scale Overpayments Overpayment Notification Process Timeline for Processing a Demand Letter [Return to Top] Forms You'll Need Forms for non MSP-related are generally done via NGSConnex, but [...]
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Posting Date: 06/04/2025
Nettings/Offsets Across Organization Affiliations
Effective 1/4/2016, CMS implemented a change to begin netting/offsetting provider money across affiliated providers within the same and also across workloads within a single organization. This CMS change brings consistency to all Part B [...]
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Posting Date: 06/04/2025
Set Up an Extended Repayment Schedule
Forms you’ll need J6 Applying for an Extended Repayment Schedule JK Applying for an Extended Repayment Schedule If repaying an overpayment would constitute a “hardship” on the provider, a request for an ERS should be submitted [...]
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Posting Date: 06/04/2025
Request an Immediate Recoupment
Forms You’ll Need These forms apply to providers that are NOT on Automatic Immediate Recoupments. Electronic Submissions JK or J6 Immediate Recoupment Request Form - Electronic/E-mail Paper Submissions Jurisdiction K [...]
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Posting Date: 06/04/2025
Respond to a Demand Letter
Table of Contents Form(s) you’ll need Timeline for Processing a Demand Letter [Return to Top] Form(s) you’ll need Providers on Automatic immediate Recoupments Do nothing as this automation process will automatically be done and [...]
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Posting Date: 06/04/2025
MSP Post-Pay Overpayments
Forms You’ll Need Jurisdiction K CT-MA-ME-NH-NY-RI-VT Medicare Part B MSP Overpayment Request Form Jurisdiction 6 IL-MN-WI Medicare Part B MSP Overpayment Request Form JK or J6 Medicare Secondary Payer Part B Voluntary [...]
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Posting Date: 06/04/2025
Advanced Payments to Providers
A provider may request an accelerated/advance payment where delays in payments by an A/B MAC for covered services rendered to beneficiaries have caused financial difficulties for the provider. An accelerated/advance payment may also be made in [...]
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Posting Date: 06/04/2025
Overpayment Rebuttal Process
You’ll need to know what the rebuttal process is before initiating and know that the outcome of the rebuttal may not change the National Government Services recoupment process. The overpayment rebuttal process is a protocol used when an [...]
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Posting Date: 06/04/2025
Observance of Juneteenth Holiday
Observance of Juneteenth Holiday In observance of Juneteenth, the National Government Services offices will be closed on Thursday, 6/19/2025. This includes the following departments: EDI Help Desk* Provider Contact Center Provider [...]
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Posting Date: 02/04/2022
Targeted Probe and Educate Educational Videos
Targeted Probe and Educate Educational Videos Video Description MAC Medical Review Best Practices: Updating Your Contact Information Did you know providers can now designate a separate [...]
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Posting Date: 01/01/1970
Targeted Probe and Educate
Targeted Probe and Educate Targeted Probe and Educate Table of Contents Targeted Probe and Educate Key Elements of TPE Provider Tips Related Content [Return to Top] National Government Services restarted targeted probe and educate reviews on [...]
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Posting Date: 02/04/2022
Medical Review: Targeted Probe and Educate Review Topics
Medical Review: Targeted Probe and Educate Review Topics Prevent technical denials by ensuring your medical records are legible and include a valid, legible provider signature. If you notice the provider signature is illegible when asked to [...]
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Posting Date: 01/01/1970
B_How to Proactively Address Denials
How to Proactively Address Denials How to Proactively Address Denials Want to improve the Payment Error Rate for the next round of review? Be sure to learn about and understand claim denials before the end of round education with the Case [...]
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Posting Date: 06/04/2025
Some Claims Editing for Reason Code U537I, HH Claim Falls Outside of an HH Admission Period for the Same Provider
Note: This issue was originally reported and resolved in April 2025. The issue has returned so we have reopened the alert. The CWF can only hold the 36 most recent periods of care for any beneficiary. CWF also contains the indicator of when [...]
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Posting Date: 05/14/2025
NGSConnex: Part B Redetermination Electronic Notification of Decision Letters
National Government Services will discontinue issuing paper Medicare Part B redetermination requests that are submitted electronically through our portal, NGSConnex. Instead, they will only be accessible to view and print electronically through [...]
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Posting Date: 05/14/2025
Provider Enrollment: Eliminate Development Request for Additional Information
Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]
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Posting Date: 05/14/2025
Home Health and Hospice New Provider Orientation
This webinar is designed for new home health and hospice agencies in an effort to provide essential information on: Doing business with National Government Services as your Medicare Administrative Contractor, Self-service tools to help make [...]
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Posting Date: 05/14/2025
Provider Enrollment: Eliminate Development Request for Additional Information
Provider Enrollment: Eliminate Development Request for Additional Information To eliminate requests for additional information and documentation on provider enrollment applications, ensure all necessary actions are complete before submission. [...]
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Posting Date: 05/13/2025
Register Now and Join Us!
Register Now and Join Us! June 3-5, 2025 There's still time to register for the 2025 Spring Part B Virtual Conference. Immerse yourself in expert-led sessions designed to transform compliance understanding into action. Posted 5/13/2025
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Posting Date: 05/13/2025
Getting Access to PECOS
During this webinar, we’ll discuss how to obtain access to the Internet-based Provider Enrollment Chain & Ownership System (PECOS) and gain connection to provider enrollment record as well as understand other Centers for Medicare & [...]
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Posting Date: 05/13/2025
Complying with Medicare Signature Requirements
Complying with Medicare Signature Requirements Medicare Compliance: Verify signature requirements have been met before you submit your medical records to prevent CERT errors. Review the CERT Alert article Signature [...]
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Posting Date: 05/13/2025
Hospice Billing Coffee Break
Provider Outreach and Education is hosting a 30-minute coffee break to help answer your troublesome hospice billing questions. This is a great opportunity to discuss areas of billing more in depth and review helpful guides and resources. Keep [...]
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Posting Date: 05/13/2025
Medicare Part B Preventive Services: Intensive Behavioral Therapy for Obesity and Depression Screening
During this webinar, we'll review the Medicare coverage, coding and billing guidelines for intensive behavioral therapy for obesity and screening for depression in adults.
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Posting Date: 05/13/2025
PECOS: View and Manage Reassignments through Group Enrollment
During this webinar, we’ll provide an understanding of how to view and manage reassignments through the group enrollment in Provider Enrollment, Chain and Ownership System (PECOS), including to add or terminate reassignments. Individual [...]
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Posting Date: 05/13/2025
Provider Enrollment Revalidation Overview
During this webinar, learn about important changes in the revalidation process, how to determine Medicare enrollment revalidation due date and information to avoid disruption in Medicare billing.
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Posting Date: 05/09/2025
Federally Qualified Health Center Basic Billing and Reimbursement
Are you a federally qualified health center (FQHC) provider eager to deepen your understanding of billing and reimbursement under FQHC prospective payment system (PPS)? Whether you're new to the role or just need a refresher, this webinar [...]
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Posting Date: 05/09/2025
Podiatry Services - Routine Foot Care and Debridement of Nails
While the Medicare Program generally excludes routine foot care services from coverage, there are specific indications or exceptions under which there are program benefits. Medicare payment may be made for routine foot care when the patient has [...]
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Posting Date: 05/09/2025
Home Health Billing Coffee Break
Provider Outreach and Education is hosting a 30-minute coffee break to help answer your troublesome billing questions. This is a great opportunity to discuss areas of billing more in depth and review helpful guides and resources. Keep in mind [...]
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Posting Date: 05/09/2025
Critical Care and Medicare Billing Compliance
While critical care codes did not change with the 2021 or 2023 AMA CPT updates, there are a lot of guidelines for billing these services. During this webinar, we'll discuss critical care coding, what is and is not critical care, how to [...]
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Posting Date: 05/08/2025
Telehealth & Remote Patient Monitoring Updates
Telehealth & Remote Patient Monitoring Updates The CMS MLN Booklet® Telehealth & Remote Patient Monitoring has been updated with important information effective 10/1/2025. Posted 5/8/2025
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Posting Date: 05/15/2025
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 [...]
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Posting Date: 11/03/2022
Paperwork Segment – PWK
Paperwork Segment – PWK PWK is a segment in the 837 electronic claim transaction. It links an electronic claim with the supporting documentation submitted by the provider. PWK indicators on the electronic claim notify NGS that documentation [...]
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Posting Date: 05/15/2025
Paperwork Segment – PWK
Paperwork Segment – PWK The paperwork segment of an electronic claim submission is commonly known as PWK. PWK can be used when an electronically submitted claim requires additional documentation for purposes of claim processing. View our [...]
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Posting Date: 04/25/2024
Local Coverage Determination Open Meeting Announcement
Local Coverage Determination Open Meeting Announcement Table of Contents Jurisdiction 6/Jurisdiction K Part A/Part B MAC Requests to Present Registered Presenters (Slide Presentations Only) Observers Comments on Proposed LCDs [...]
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Posting Date: 01/01/1970
Biomarker Testing for Neuroendocrine Tumors/Neoplasms
Biomarker Testing for Neuroendocrine Tumors/Neoplasms N/A L37851 https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=37851 A57059 https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57059 A56247 [...]
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Posting Date: 05/13/2025
MLN Connects® Newsletter: May 13, 2025
MLN Connects® Newsletter: May 13, 2025 News CMS Seeks Public Input on Improving Technology to Empower Medicare Beneficiaries Posted 5/13/2025
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Posting Date: 05/15/2025
MLN Connects® Newsletter: May 15, 2025
MLN Connects® Newsletter: May 15, 2025 News CMS Releases Draft Guidance for the Third Cycle of Medicare Drug Price Negotiation Program to Lower Drug Prices for American Patients Opioid Treatment Programs: CY 2025 Updates Laboratories: [...]
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Posting Date: 05/15/2025
Private Practice Physical/Occupational Therapy Billing
We invite you to join our informative webinar focused on billing guidelines for physical and occupational therapy in private practice. During this webinar, we'll review important topics such as the appropriate use of the KX modifier and the [...]
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