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Posting Date: 06/12/2025
Submitting Revalidation via PECOS
During this webinar, we’ll provide an understanding of how to utilize the Centers for Medicare & Medicaid Services (CMS) Internet-based Provider Enrollment Chain & Ownership System (PECOS) to be comfortable in navigating the system to [...]
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Posting Date: 06/12/2025
PECOS: Manage Signatures and Additional Information Requests
During this webinar, we’ll give direction for the Provider Enrollment, Chain and Ownership System (PECOS) application on understanding how to manage signatures and respond to additional information request from submitted applications.
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Incision and drainage of abscess (e.g., carbuncle, suppurative hidradenitis, cutaneous or [...]
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Posting Date: 06/12/2025
Understanding the Submission Requirement for a Revalidation Application
Understanding the Submission Requirement for a Revalidation Application According to the 42 Code of Federal Regulations Section 424.515(b), providers and suppliers are required to submit a CMS-855 application with complete information for [...]
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Posting Date: 06/11/2025
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: 06/11/2025
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: 06/11/2025
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: 06/11/2025
Provider Enrollment: Completing the CMS-855B Paper Application
During this webinar, we'll provide an understanding of how to complete the CMS-855B provider enrollment paper application for a clinic, group or supplier.
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Posting Date: 06/12/2025
Medicare Secondary Payer: A Review of the Disabled with a Large Group Health Plan Provision
In this webinar, we will review the criteria of the Disabled with a Large group health plan (LGHP), Medicare Secondary Payer (MSP) provision. Understanding this criteria will help your facility identify and bill the appropriate primary payer [...]
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Posting Date: 06/13/2025
Inpatient Rehabilitation Facilities: Preparing and Submitting Compliant Claims to Medicare
In this webinar, we will review Medicare's general inpatient billing requirements for Inpatient Rehabilitation Facility including bill types, billing frequency, interim billing, benefits exhaust billing, billing when claims are paid by [...]
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Posting Date: 06/22/2022
Standard Companion Guide Trading Partner Information
Standard Companion Guide Trading Partner Information Instructions Related to the X12 275 Claims Attachment Version 6020 and HL7 Consolidated Clinical Document Architecture R2.1 Companion Guide Version Number: 9.0 Revised: June 2025 Preface [...]
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Posting Date: 08/15/2022
Eligible Method II Providers
Eligible Method II Providers If a CAH wants to become a Method II biller, email the request to A&R at ngsreimbursement@anthem.com. Suppliers who can enroll as a Method II Biller Reassignment. Doctor of Medicine (MD) Doctor of [...]
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Posting Date: 06/16/2025
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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Posting Date: 06/16/2025
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 [...]
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Posting Date: 06/16/2025
The National Correct Coding Initiative and Medically Unlikely Edits for Part B Providers
This webinar will assist Part B providers with navigating tables for the National Correct Coding Initiative and the medically unlikely edits. We'll also review the proper modifiers to use to avoid denials. There will be time for your [...]
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Posting Date: 06/16/2025
Interactive Voice Response System Changes Coming Soon
Interactive Voice Response System Changes Coming Soon We’re making changes to our IVR system. You’ll still dial the same number, but you’ll hear a new voice. Although the IVR provides instructions throughout the call, we want to point out some [...]
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Posting Date: 01/01/1970
Part A - Promo 1
Banner saying "NGS RuralServ - Changing the way we deliver education to you." /web/ngs/ruralserv?selectedArticleId=1987743&lob=96664&state=97178&rgion=93623
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Posting Date: 06/16/2025
Medicare Part B Ambulance Coverage, Basics and Billing
During this webinar, we'll educate new staff or those needing a refresher on basic Medicare Part B ambulance billing guidelines.
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Posting Date: 06/16/2025
Medicare Portable X-Ray Survey Reminder
Medicare Portable X-Ray Survey Reminder MACs, under the direction of the CMS, are conducting a national cost analysis survey to assess the transportation components of portable X-ray services, specifically HCPCS codes R0070 and R0075. This [...]
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Posting Date: 07/14/2022
View a General Inquiry
View a General Inquiry Table of Contents View a General Inquiry Attachments [Return to Top] View a General Inquiry National Government Services, Inc. will respond to your inquiry via NGSConnex within 45-business days of the date your [...]
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Posting Date: 10/28/2021
Other Audit Contractor ADRs
Other Audit Contractor Additional Development Requests Origins Facts Identification Comprehensive Error Rate Testing (CERT) Office of Inspector General (OIG) Recovery Auditor Contractors (RAC) [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction 6 HH+H Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Services - Medical Necessity ICD-10 Z47-Z47.89 N/A 55H3V – The documentation did [...]
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Posting Date: 06/17/2025
Holding MSP Claims Receiving CWF Edit 6802
Certain MSP claims are incorrectly rejected against CWF edit 6802. On 4/24/2025, CMS directed MACs to hold all MSP claims editing with 6802 while CWF works to correct the issue.
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Posting Date: 09/21/2020
Interactive Voice Response System
Interactive Voice Response System State IVR Number Hours Available* Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, Vermont 877-567-7205 Monday–Friday: 6:00 a.m.–7:00 p.m. ET [...]
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Posting Date: 04/22/2021
Provider Contact Center
Provider Contact Center Table of Contents Want to talk to us? Make the Most of Your Call Customer Care Representative Assistance Interactive Voice Response System NGSConnex Online Inquiry System Freedom of Information Act (FOIA) [...]
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Posting Date: 04/01/2020
EDI Help Desk Information
EDI Help Desk Information Toll-Free Number Jurisdiction 6: 877-273-4334 Jurisdiction K: 888-379-9132 Hours of Operation Monday–Friday: 8:00 a.m.–5:00 p.m. ET * Closed for training on the 2nd and 4th Friday of the month from 12:00–4:00 [...]
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Posting Date: 06/01/2018
Avoiding Reason Code 38200
Avoiding Reason Code 38200 Claims are rejected with reason code 38200 when the FISS finds a previously submitted billing transaction that is a duplicate of the recently submitted billing transaction where all of the following fields on the [...]
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Posting Date: 07/14/2024
Correcting Reason Code 37253
Correcting Reason Code 37253 To ensure home health claim information aligns with OASIS data, the iQIES OASIS claim data match is essential. If no matching assessment is found in iQIES when a claim is submitted, it will be returned with reason [...]
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Posting Date: 05/08/2023
Home Health Billing When a New MBI is Assigned
Home Health Billing When a New MBI is Assigned A patient’s MBI number is required on all home health billing submitted to Medicare. CMS will issue a new MBI when an original MBI may have been, or has been compromised. There are times a home [...]
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Posting Date: 01/13/2022
Billing the Home Health Notice of Admission Electronically
Billing the Home Health Notice of Admission Electronically Table of Contents Billing the Home Health Notice of Admission Electronically NOA Claim Page 1 NOA Claim Page 2 NOA Claim Page 3 NOA Claim Page 4 NOA Claim Page 5 [...]
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Posting Date: 12/30/2022
Telehealth Home Health Services
Telehealth Home Health Services Prior to 1/1/2023, data on telecommunications technology used during a 30-day period of care at the patient level was not collected on HH claims. On 7/1/2023 reporting telecommunications G codes became [...]
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Posting Date: 11/21/2024
Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q)
Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q) This stringent claim editing process helps ensure that Medicare does not make payments for services rendered to beneficiaries who are not eligible due to being [...]
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Posting Date: 07/14/2024
Expanded Home Health Value-Based Purchasing Model
Expanded Home Health Value-Based Purchasing Model Overview The HHVBP Model is an initiative by CMS aimed at improving the quality of care provided by home health agencies while also fostering greater efficiency. It builds on the original [...]
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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” [...]
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Posting Date: 05/19/2022
Billing the Home Health Period of Care Claim - PDGM
Billing the Home Health Period of Care Claim – PDGM Table of Contents Billing the Home Health Period of Care Claim – PDGM Claim Page 1: Claim Page 2: Claim Page 3 Claim Page 4 Claim Page 5 Related Resources [Return to Top] [...]
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Posting Date: 05/19/2022
Home Health Third Party Liability Demand Billing
Home Health Third Party Liability Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a TPL Demand Bill Claim Page 1: Claim Page 2 – Covered and Noncovered Charges Claim [...]
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Posting Date: 01/13/2022
Billing the Home Health Notice of Admission via DDE
Billing the Home Health Notice of Admission via DDE Table of Contents Billing the Home Health Notice of Admission via DDE NOA Claim Page 1 NOA Claim Page 4 Notes Related Content [Return to Top] Billing the Home Health [...]
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Posting Date: 02/26/2016
Reporting Home Health Periods with No Skilled Visits
Reporting Home Health Periods with No Skilled Visits Eligibility for the Medicare HH benefit requires that the beneficiary have a need for intermittent skilled nursing care, PT, SLP, or a continuing need for OT. The need for skilled care makes [...]
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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 [...]
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