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Posting Date: 07/05/2022
Targeted Probe and Educate Review Topics
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 supply medical [...]
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Posting Date: 07/05/2022
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: 02/09/2022
Targeted Probe and Educate Educational Videos
Targeted Probe and Educate Educational Videos Video Description Targeted Probe and Educate Learn more about the TPE Program. Additional educational information can be found on our Events page [...]
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Posting Date: 02/09/2022
Targeted Probe and Educate Review Topics
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 supply medical [...]
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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: 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: 06/05/2025
Rural Emergency Hospital Basics
Do you know what a Rural Emergency Hospital (REH) is and what services can be provided? Part A facilities, including Critical Access Hospitals and small rural hospitals, are eligible to enroll as a REH. Join this session to learn more about the [...]
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Posting Date: 08/15/2023
Medicare Part B Coverage and Billing Guidance for Breast Ultrasound
Medicare Part B Coverage and Billing Guidance for Breast Ultrasound Breast ultrasound uses sound waves to produce pictures of the inside of the breast and can show changes that are more difficult to see on a mammogram. Breast ultrasound is not [...]
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Posting Date: 06/05/2025
Part A Summit - NGSConnex: User Pain Points Examples/Solutions
Are you experiencing issues while utilizing NGSConnex? Join this informative session to learn what user pain points are and how to resolve these issues from an NGSConnex Agile Product Owner. This session will encompass issues with [...]
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Posting Date: 06/05/2025
Part A Summit – How to Submit an Appeal Request
Join us for a comprehensive session focused on understanding the appeal submission process within National Government Service. This presentation is designed to guide participants through each step of submitting an appeal, ensuring clarity and [...]
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Posting Date: 06/05/2025
Part A Summit- Skilled Nursing Facility: Coverage and Documentation
During this collaborative education session between Case Management and Medical Review, attendees will learn documentation requirements for skilled nursing facility (SNF) coverage, how to properly respond to Additional Documentation Requests [...]
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Posting Date: 06/05/2025
Part A Summit- Navigating Billing and Documentation for Behavioral Health Services in Federally Qualified Health Centers
Unlock the secrets to effective billing and documentation for behavioral health services within Federally Qualified Health Centers. This collaborative webinar will include insights from Medical Review and is designed to help healthcare [...]
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Posting Date: 06/09/2025
Medicare Secondary Payer: A Review of the Working Aged with an Employer Group Health Plan Provision
In this webinar, we will review the criteria of the Working Aged with an Employer group health plan (EGHP), Medicare Secondary Payer (MSP) provision. Understanding this criteria will help your facility identify and bill the appropriate primary [...]
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Posting Date: 01/14/2022
Meeting Schedule for Home Health and Hospice
Meeting Schedule for Home Health and Hospice Jurisdiction 6 (Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Island, Oregon, Puerto Rico, U.S. Virgin [...]
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Posting Date: 06/09/2025
[RESOLVED] Fiscal Intermediary Standard System and Multi Carrier System Experiencing Outages
[RESOLVED] Fiscal Intermediary Standard System and Multi Carrier System Experiencing Outages The FISS and MCS are now available and Part A and Part B providers can check claim status in NGSConnex and the IVR system. We apologize for any [...]
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Posting Date: 06/10/2025
Part A Summit - Maintaining Your Provider Files
This virtual webinar will aid in maintaining accurate provider enrollment files for the internet-based Centers for Medicare & Medicaid Services systems: Identity & Access Management System, National Plan & Provider Enumeration [...]
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Posting Date: 06/10/2025
Part A Summit- Navigating NGS and CMS Websites
Join us for this informative session where we will review how to find helpful Medicare references and resources on the National Government Services website (www.NGSMedicare.com) and the Centers for Medicare & Medicaid Services website [...]
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Posting Date: 01/04/2022
Meeting Schedules
Meeting Schedules Jurisdiction 6: Illinois, Minnesota, Wisconsin Jurisdiction K: Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont Meeting Date/Time Provider Type Chairpersons [...]
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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: 06/06/2025
Part A Summit Let’s Chat: Prior Authorization for Certain Hospital Outpatient Department Services
This Let’s Chat session focuses on Prior Authorization for certain hospital outpatient department (OPD) services and is an informal opportunity for you to chat with our staff about the selected topic. During the session, you may ask us [...]
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Posting Date: 11/16/2021
Jurisdiction 6 State Licensing and Certification Websites
Jurisdiction 6 State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within J6 that can be used to verify your status. Table of Contents Illinois Minnesota [...]
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Posting Date: 04/15/2022
Jurisdiction K State Licensing and Certification Websites
Jurisdiction K State Licensing and Certification Websites The following list contains helpful links to websites of some organizations within JK that can be used to verify your status. Table of Contents Connecticut Maine [...]
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Posting Date: 08/21/2018
Certified Provider and State Survey Agency
Certified Provider and State Survey Agency Table of Contents Certified Provider and State Survey Agency Certified Providers/Suppliers Certified Providers and Certified Suppliers That Enroll Via the Form CMS-855A Certified Suppliers That [...]
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Posting Date: 08/21/2018
State License and Registrations for Individuals and Organizations
State License and Registrations for Individuals and Organizations Prior to submitting a provider enrollment application to Medicare, ensure that all applicable state licensing and/or specialty certification requirements are current. Each state [...]
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Posting Date: 01/17/2017
State License and Registrations for Individuals and Organizations
State License and Registrations for Individuals and Organizations Prior to submitting a provider enrollment application to Medicare, ensure that all applicable state licensing and/or specialty certification requirements are current. Each state [...]
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Posting Date: 12/05/2016
Eligible Physicians
Eligible Physicians Physicians who can enroll in Medicare: Doctor of: Medicine (MD) Osteopathy (DO) Chiropractic (DC) Dentistry (DMD) (DDS) Optometry (OD) Psychiatry (MD) Podiatry (DPM) Reviewed 6/12/2025
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Posting Date: 12/05/2016
Eligible Nonphysicians
Eligible Nonphysicians Nonphysician Practitioners who can enroll in Medicare. Below you can find the definition, qualifications and supporting documentation for each specialty. Visit Obtain/Verify State License for assistance with license [...]
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Posting Date: 08/21/2018
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only
Eligible Part B Physicians and Nonphysicians to Enroll as Ordering and Referring Only Physician and nonphysician practitioners who can enroll in Medicare solely to order or refer: Doctors of medicine or osteopathy Doctors of dental surgery [...]
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Posting Date: 04/08/2021
Eligible Part B Suppliers
Eligible Part B Suppliers Suppliers who can enroll in Medicare: Ambulance Service Supplier Ambulatory Surgical Centers (ASC) Clinic/Group Practices Hospital Department(s) Home Infusion Therapy (HIT) Independent Clinical Laboratory [...]
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Posting Date: 06/12/2025
MLN Connects® Newsletter: June 12, 2025
MLN Connects® Newsletter: June 12, 2025 News Final National Coverage Determination: Noninvasive Positive Pressure Ventilation in Home for Treatment of Chronic Respiratory Failure Consequent to COPD Skilled Nursing Facility Value-Based [...]
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Posting Date: 08/24/2022
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, [...]
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Posting Date: 05/05/2021
Description of NPI and a Link to NPPES Registry
Description of NPI and a Link to NPPES Registry As mandated by HIPAA, you should maintain (verify and update) your NPI data via NPPES on a regular basis. The NPI: is a ten-digit number and must be submitted on the enrollment form, will [...]
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Posting Date: 06/12/2025
Provider Enrollment: Completing the CMS-855A Paper Application
During this webinar, we’ll provide an understanding of how to complete the CMS-855A provider enrollment paper application.
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Posting Date: 06/12/2025
Provider Enrollment: Completing the CMS-855I Paper Application
During this webinar, we’ll provide an understanding of how to complete the CMS-855I provider enrollment paper application for a group member, sole proprietor or sole owner and we’ll also focus on reassigning Medicare benefits.
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