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Posting Date: 05/09/2022
Home Health Transfers
Home Health Transfers Table of Contents Background What To Do As a Receiving HHA What To Do As the Initial HHA What To Do In Case of a Dispute Related Content [Return to Top] Background A home health transfer occurs when a [...]
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Posting Date: 12/05/2017
Disposable Negative Pressure Wound Therapy Services Under Home Health
Disposable Negative Pressure Wound Therapy Services Under Home Health Effective for services furnished on or after 1/1/2017, Medicare will make separate payment to HHAs for dNPWT services for patients under the home health benefit. NPWT [...]
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Posting Date: 05/09/2022
Home Health Agency Transfer and Dispute Protocol
Home Health Agency Transfer and Dispute Protocol Specific protocol and steps must be followed prior to opening an admission period for a new patient. Step One: Verify the patient’s eligibility You must ensure the patient is not [...]
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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 [...]
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Posting Date: 05/19/2022
Home Health Demand Billing
Home Health Demand Billing Table of Contents Background What is a Demand Bill? Requirements for Submission How to Submit a Demand Bil Claim Page 1: Claim Page 2: Covered and Noncovered Charges Claim Page 2: All Noncovered Charges [...]
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Posting Date: 06/23/2025
Billing Telehealth Services for Part B Providers
During this webinar, we’ll provide you with insight into covered Medicare telehealth services and coverage requirements. We’ll discuss originating sites, distant sites and billing and payment guidelines.
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Posting Date: 07/12/2024
Hospice Transfers
Hospice Transfers The purpose of a hospice transfer is to allow the beneficiary the opportunity to transfer to another agency without affecting the current benefit period and providing continuity of care. Instead of the beneficiary revoking [...]
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Posting Date: 10/22/2015
Hospice Documentation Tips
Hospice Documentation Tips Medicare coverage of hospice depends on a physician’s certification that an individual’s prognosis is a life expectancy of six months or less if the terminal illness runs its normal course. It is important that the [...]
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Posting Date: 10/05/2022
Tips for Responding to a Hospice ADR
Tips for Responding to a Hospice ADR National Government Services performs medical review audits of services billed to Medicare to validate that the documentation supports coverage and level of services billed. If one of your claims is [...]
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Posting Date: 10/04/2021
Implementation of the Election Statement Addendum
Implementation of the Election Statement Addendum Hospice Election Statement Addendum Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled to [...]
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Posting Date: 10/04/2021
Documentation Requirements for the Medicare Hospice Election Statement
Documentation Requirements for the Medicare Hospice Election Statement Election of Hospice Hospice care is a benefit under the hospital insurance program. To be eligible to elect hospice care under Medicare, the beneficiary must be entitled [...]
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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 [...]
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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 [...]
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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 [...]
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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 [...]
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Posting Date: 07/18/2023
Medical Review: Targeted Probe and Educate Review Topics
Jurisdiction K Part B Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Paring or Cutting of Benign Hyperkeratotic Lesion 11055, 11056, 11057 A07 – The [...]
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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 [...]
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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 [...]
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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, [...]
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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 [...]
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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. [...]
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Posting Date: 03/08/2021
Related Content
Related Content WPC Health Care Code Lists Health Care Payment and Remittance Advice: Provides information on ERA and companion documents for assistance with receiving the Transaction 835. CMS IOM Publication, Medicare Claims Processing [...]
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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. [...]
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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 [...]
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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 [...]
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Posting Date: 01/03/2024
About PC-ACE
About PC-ACE The National Government Services PC-ACE free billing software is available for NGS J6 and JK providers only. If you are not a J6 or JK provider, the free billing software must be obtained from your MAC. PC-ACE is a [...]
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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 [...]
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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 [...]
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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 [...]
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Posting Date: 01/29/2020
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: [...]
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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 [...]
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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 [...]
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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 [...]
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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) [...]
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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 [...]
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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 [...]
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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, [...]
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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 [...]
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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 [...]
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Posting Date: 01/03/2024
Download PC Print
Download PC Print Please select from the two available versions of PC Print below. PC Print 7.1.5 PC Print 9.3.2 For the most current CARC/RARC code sets with full narrative and business scenarios, please download PC Print 9.3.2. and [...]
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