Targeted Probe and Educate Letters – An Informational Overview

Targeted Probe and Educate Letters – An Informational Overview As part of our contractual obligation with the CMS, NGS, your Jurisdiction 6 or K MAC performs TPE to analyze provider compliance with CMS regulatory requirements. The TPE review [...]

Health and Human Services Office of Inspector General Telehealth and Potential Fraud

Health and Human Services Office of Inspector General Telehealth and Potential Fraud The DHHS, of whom the CMS reports to, published a brief last week from the OIG regarding telehealth and the PHE expansion of services. The article addresses [...]

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments

Understanding your Remittance Advice for Merit-Based Incentive Payment System Adjustments National Government Services has seen an increase in invalid overpayment requests related to the MIPS program. MIPS is part of the QPP that determines [...]

MLN Connects® Special Edition for Thursday, February 3, 2022

MLN Connects® Special Edition for Thursday, February 3, 2022 Biden-Harris Administration Will Cover Free Over-the-Counter COVID-19 Tests Through Medicare CMS Developing Initiative to Enable Access to Eight Free Over-the-Counter COVID-19 Tests [...]

Provider Enrollment Authorization and Accreditation

​​​​​​​Provider Enrollment Authorization and Accreditation Provider Enrollment added articles State License and Registrations for Certified Providers and Suppliers and Certified Provider and State Survey Agency for reminders, clarification and [...]

Top Claim Errors

Top Claim Errors Did you know we publish the top claim errors on our website? This information provides you with: the error reason code; a description of the error; the error type; details that include steps you can take to [...]

Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Jurisdiction 6 State Licensing and Certification Websites

Jurisdiction K State Licensing and Certification Websites

Provider Enrollment: Obtaining and Verifying State License

Provider Enrollment: Obtaining and Verifying State License Providers must contact their State agency when initially enrolling or making a change to a current Medicare enrollment for certification materials for their provider/supplier type. For [...]

Certified Provider and State Survey Agency

Certified Provider and State Survey Agency

MLN Connects® Newsletter for Thursday, August 4, 2022

MLN Connects® Newsletter for Thursday, August 4, 2022 ICD-10-CM Code Files: Fiscal Year 2023 News Hospices: Volunteer to Test Hospice Outcomes & Patient Evaluation Instrument Immunization: Protect Your Patients Claims, Pricers, [...]

Modifier 52 Claim Submission Billing Reminder

Modifier 52 Claim Submission Billing Reminder National Government Services found that on many occasions, providers are billing for reduced services with modifier 52 appended to the CPT code; however, they are billing the regular charged amount [...]

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022

Comprehensive Error Rate Testing Redetermination Deadline 9/27/2022 The CERT RY 2022 is quickly coming to an end. The deadline for redetermination completion is 9/27/2022 to be considered for the CERT RY. National Government Services requests [...]

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022

Comprehensive Error Rate Testing Documentation Deadline 8/22/2022 The CERT RY 2022 is quickly coming to an end. In order to give sufficient time for the CERT RC to complete the review of your claims, all documentation and additional [...]

October 2022 Release "Dark Days" for the Common Working File Hosts

October 2022 Release "Dark Days" for the Common Working File Hosts For the upcoming October 2022 Release: For Production, CWF will be observing the Gray Day on Thursday, September 29th and Dark Days starting Friday, September 30th through [...]

MLN Connects® Newsletter for Thursday, August 11, 2022

MLN Connects® Newsletter for Thursday, August 11, 2022 Monkeypox & Smallpox Vaccines: New Product Codes News Monkeypox & Smallpox Vaccines: New Product Codes Payment Allowance Update for COVID-19 Monoclonal Antibody Therapy [...]

CMS Identifies National System Issue

CMS Identifies National System Issue CMS identified a national system issue, which may have inadvertently adjusted previously processed Part B claims with dates of service (DOS) on or after January 1, 2021. These adjustments processed on July [...]

National Government Services Medicare Spring 2022 Virtual Conference

National Government Services Medicare Spring 2022 Virtual Conference Medicare For You Wednesday, 5/11/2022 – Thursday, 5/12/2022 The NGS Provider Outreach and Education Team is holding our latest bi-annual virtual conference on Wednesday, [...]

Log Out

Log Out You will be logged out of NGSConnex automatically after 30-minutes of inactivity. This is a CMS - security requirement to protect provider and beneficiary information. When you are ready to exit the system, click Log Out icon located [...]

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow!

Are You Registered? The Spring 2022 Virtual Conference Medicare for You Begins Tomorrow! Medicare for You offers valuable information that is fundamental for you, as a provider, to submit claims with the needed information so you realize the [...]

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials

Submit an Adjustment to Correct Claims Partially Denied by Automated LCD-NCD Denials NGS would like to remind providers that using adjustment reason code “LN” to submit adjusted claims (xx7, xxQ), where changes were made to an LCD/NCD denied [...]

Screen Movements

  Chapter III: Navigating the Online System Screen Movements Purpose To move within the FISS/DDE Provider Online System, providers will perform several different screen movements. The following chart outlines the various screen [...]

MLN Connects® Newsletter for Thursday, August 18, 2022

MLN Connects® Newsletter for Thursday, August 18, 2022 Discontinuing Use of Certificates of Medical Necessity & Durable Medical Equipment Information Forms    News CMS Discontinuing the Use of Certificates of Medical [...]

Accessibility Statement

Accessibility Features of the National Government Services Website The NGSMedicare.com website employs many features to make information more accessible. If you have comments or suggestions, please use our Site Feedback mechanism to let us [...]

MLN Connects® Special Edition for Thursday, August 18, 2022

MLN Connects® Special Edition for Thursday, August 18, 2022 Creating a Roadmap for the End of the COVID-19 Public Health Emergency News Creating a Roadmap for the End of the COVID-19 Public Health Emergency Health Care System Resiliency [...]

Ambulance Services and the Advance Beneficiary Notice of Noncoverage

Ambulance Services and the Advance Beneficiary Notice of Noncoverage To follow are Medicare’s guidelines regarding the use of an ABN for ambulance services. Per the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) [...]

Level 1: Redetermination Request Form

Ensure Accurate Provider Enrollment Information on File

Ensure Accurate Provider Enrollment Information on File ATTENTION: Claims and Provider Enrollment Verify that accurate provider enrollment information is on file with Medicare. Are you familiar with the details identified in the PECOS system [...]

Medical Review: Targeted Probe and Educate Review Topics

Jurisdiction K HHH Targeted Probe and Educate: Medical Review Topics Topic CPT Code(s) Common Denials Resources Home Health Medical Necessity N/A 55H3V– The documentation did not support the medical [...]

Understanding the Approval Recommendation Process for Certified Providers

Understanding the Approval Recommendation Process for Certified Providers The certified provider completes and submits a CMS-855 enrollment application and all supporting documentation to its MAC, including any state require documentation [...]

Ambulance Duplicate Claim Denials

Ambulance Duplicate Claim Denials Duplicate trips may be reported on the same claim if the ZIP code for the point of pick-up for both trips is the same. If separate claims are submitted for the same beneficiary on the same day with the same [...]

Top JK Part B Claim Errors are Available

Top JK Part B Claim Errors are Available We conduct a comprehensive data analysis on a quarterly basis to update and disseminate the latest insights on the most common claim errors. This initiative provides:  Claim Error Reason Code [...]

Ambulance Billing Guidance

Ambulance Billing Guidance Table of Contents Ambulance Billing Ambulance Billing HCPCS Codes How to Bill Units with Transpiration HCPCS Codes Using Ambulance Modifiers When Billing Transportation Indicators Related Content [Return [...]

MLN Connects® Newsletter: March 27, 2025

MLN Connects® Newsletter: March 27, 2025 News Extension of Medicare Provisions Final National Coverage Determination: Transcatheter Tricuspid Valve Replacement Nutrition-Related Health Conditions: Recommend Medicare Preventive Services [...]

Fundamentals of Medicare

Reopening versus Redetermination

Reopening versus Redetermination Table of contents Reopening versus Redetermination Reopening Telephone Reopening Unit Redeterminations [Return to Top] Reopening versus Redetermination Understanding your next steps are very [...]

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 Software – For Professional Users: Importing and Reading the 999 & 277CA Files [...]