Medicare Secondary Payer Payment Methodology

Please join us for this learning session on how MSP payments are calculated. It’s essential for providers and their staff members to be able to determine the beneficiary’s responsibility to ensure that claims are being submitted to the Medicare [...]

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 [...]

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 [...]

Part B Medicare Administrative Contractor Overview and Coverage for Dental Services

Medicare covers a limited number of dental services. The purpose of this webinar is to familiarize dental providers with National Government Services (NGS) and Medicare Part B dental coverage. Discussion will include an overview of the NGS [...]

Medicare Physician Fee Schedule Database

Medicare offers several tools to help providers bill their services. Many questions you have can be answered by learning how to access and use the Medicare Physician Fee Schedule Database. We hope you'll join us for an overview of this database.

Medicare Part B Drugs and Biologicals

Medicare Part B covers certain drugs and biologicals, which require specific billing guidelines. During this webinar, we’ll assist NGS Part B providers in navigating proper billing for these services. There will be time following the [...]

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 [...]

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 & [...]

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.

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 [...]

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.

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.

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.

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.

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 [...]

Understanding the Federally Qualified Health Center Medicare Advantage Supplemental Payments

During this webinar, we’ll equip participants with a clear understanding of the Federally Qualified Health Center (FQHC) Medicare Advantage Supplemental Payment Program and guide participants through the necessary steps to set up and bill for [...]

Understanding the Partial Hospitalization Program Basics: Part 1 Medicare Coverage

Join us to learn about Medicare coverage of Partial Hospitalization Program (PHP) services. This is part 1 of a 2-part session. The second session “Understanding the Partial Hospitalization Program: Part 2 Medicare Billing” will be conducted on [...]

Understanding the Partial Hospitalization Program Basics: Part 2 Medicare Billing

Join us to learn about Medicare billing of Partial Hospitalization Program (PHP) services. This is part 2 of a 2-part session. The first session “Understanding the Partial Hospitalization Program: Part 1 Medicare Coverage” will be conducted on [...]

Inpatient Psychiatric Facilities: Preparing and Submitting Compliant Claims to Medicare

In this session, we will review Medicare's general inpatient billing requirements for Inpatient Psychiatric Facility's including bill types, billing frequency, interim billing, benefits exhaust billing, billing for electroconvulsive [...]

NGSConnex-Account Management

Do you need assistance with login issues and account suspensions? Do you know who your Local Security Officer is and what they are responsible for? We will also review how to edit the user profile and updating access within the portal. After [...]

NGSConnex-Account Management

Do you need assistance with login issues and account suspensions? Do you know who your Local Security Officer is and what they are responsible for? We will also review how to edit the user profile and updating access within the portal. After [...]

Mastering Critical Access Hospital Outpatient Billing

During this webinar, we’ll provide basic billing instructions for outpatient services in a Critical Access Hospital (CAC) including Method I and Method II payment methods.

Using Third Party Billing Companies

Medicare providers frequently outsource their billing, financial and enrollment services. During this webinar, we’ll highlight the need to contract with CMS-approved entities and ensure these contracts include measures to protect personally [...]

Repetitive Scheduled Non-Emergent Ambulance Transports Prior Authorization

Attention All Independent Ambulance Suppliers! If you are providing repetitive, scheduled, non-emergent ambulance transports (RSNAT), you'll want to attend this webinar. Join us to learn everything you need to know about the RSNAT program.

Introduction to Medicare Part I

Join us for Introduction to Medicare Part I, if you are a new provider/staff member or need a refresher in the Medicare Part B Program. Topics include Jurisdictions, NGS Website, Medicare Enrollment, Electronic Billing, Medicare Compliance, [...]

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.

NGSConnex: Part B Redetermination Electronic Notification Letters

National Government Services will discontinue mailing paper Medicare Redetermination Notices (MRNs) when Part B redetermination requests are submitted through NGSConnex beginning in March 2025. During this webinar, we’ll share information and [...]

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.

Navigating Skilled Nursing Facility Inpatient Billing Situations

During this session, we’ll explore how to properly bill situations that occur with skilled nursing facility inpatients such as; when the beneficiary did not meet the technical or medical requirements for coverage, has insurance primary to [...]

Top J6 Part B Claim Errors are Available

Top J6 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 [...]

Coverage Criteria and Frequency Limits

Coverage Criteria and Frequency Limits Table of Contents Counseling to Prevent Tobacco Use Diagnosis Coding Cost Sharing Reimbursement Nonparticipating Providers Related Content [Return to Top] Counseling to Prevent Tobacco Use [...]

Counseling to Prevent Tobacco Use and Tobacco Related Diseases Job Aid

April 2025 EDI Front End Quarterly Release

April 2025 EDI Front End Quarterly Release Please be advised that while the Centers for Medicare & Medicaid Services mandated release for April 2025 was installed the weekend of 4/6/2025, the code set updates included with this release [...]

Social Security Income Ratios

Social Security Income Ratios The federal fiscal year 2023 SSI ratios for IPPS hospitals, IRF and LTCH were posted on the CMS website. IPPS IRF LTCH NGS will update the latest published 2023 SSI ratios in the Provider Specific File of [...]

55B31

Avoiding/Correcting This Error Review coverage guidelines and patient records to determine if all appropriate documentation was sent for review that may have supported medical necessity.  When you receive an ADR from National Government [...]

59132

Avoiding/Correcting This Error RHCs should not bill codes G0108 or G0109. Related Content CMS Internet-Only Manual, Publication 100-04, Medicare Claims Processing Manual, Chapter 9, Section 70.5 - Diabetes Self-Management Training (DSMT) [...]

U5233

Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

U5233

Avoiding/Correcting This Error Verify the admission date, from, and through dates on the claim and compare the dates to the HMO entitlement dates. Verify the admission date, from, and through dates on the claim and compare the dates to the [...]

U5220

Avoiding/Correcting This Error Verify the MBI and date(s) of service. If services were provided prior to the date the beneficiary was entitled to Medicare, no further action is necessary. Otherwise, correct and resubmit.

34293

Avoiding/Correcting This Error Review your beneficiary’s enrollment in a Medicare HMO/MAO prior to providing services. A beneficiary may drop MAO coverage; review the CWF, IVR, NGSConnex, or HETS to identify a termination date for the MAO [...]