37236

Avoiding/Correcting This Error Verify eligibility of the attending/ordering physicians in PECOS. Print that verification and make it part of the medical record. If applicable, submit a reopen request to the Appeals Department indicating error [...]

55HTP

Avoiding/Correcting This Error Verify that the initial certification is complete and includes all necessary elements, such as the patient’s homebound status, the need for skilled services, and a face-to-face encounter with a physician or [...]

55H1L

Avoiding/Correcting This Error Clinical progress notes should show evidence of a steady decline or downward trajectory in the beneficiary’s clinical status over time. Documentation should be objective, measurable and must support a life [...]

How to Avoid and Correct Duplicate Claim Denials

How to Avoid and Correct Duplicate Claim Denials A duplicate claim submission occurs when a physician or other qualified healthcare professional resubmits a claim either on paper or electronically for a single encounter and the service is [...]

Portable X-Ray Cost Analysis Survey

Clinical Trials

Clinical Trials Clinical trials are interventional studies that assess treatments or diagnostics compromising experimental and control groups. Medicare coverage in these trials is guided by strict CMS rules and is limited to FDA-approved [...]

34538

Avoiding/Correcting This Error To avoid this error: When submitting your Medicare primary claim, report the reason Medicare is primary using claim coding in Prevent an MSP Rejection on a Medicare Primary Claim. To correct this [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

Proper Part B Claim Submissions

This webinar is intended to educate providers and office staff members on how to complete a clean claim to avoid claim rejections, developments or denials. We will guide you through the CMS-1500 claim form and the electronic equivalent loops [...]

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 [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

Steps to Claim Corrections

This webinar includes the top continuous errors we find at National Government Services with claim submissions. Join us to learn how to correct your claims. We will also include an interactive segment on the different claim scenarios that cause [...]

MSP Right Hand

Helpful Resources Verification of Medicare Secondary Payer Data  

DDE: Can a provider view additional development requests (ADRs) via the FISS/DDE?

CLAIMS: How do I indicate on a Medicare claim that the services are NOT related to a liability, no fault (including medical payment) or Workers’ Compensation accident, injury or illness MSP record in the CWF?

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.

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-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.

Critical Access Hospitals, FQHC and RHC Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us for a review of top claim errors for your provider type based on recent data [...]

Four Reasons Patients Fear Quitting Tobacco

Four Reasons Patients Fear Quitting Tobacco Stress: If you rely on cigarettes to loosen up during your day, you might worry about losing this release valve. It’s essential to remember that using nicotine to relax is only a temporary fix and [...]

IDTF Procedure Codes (65 KB)

Prior Authorization CPT/HCPCS Code Inquiry Tool

The Annual Wellness Visit: Promoting Good Health Through Disease Prevention and Detection

Medicare covers many preventive services to keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can help keep your patients from getting certain diseases. Register today for an [...]

Prior Authorization CPT/HCPCS Code Inquiry Tool

Prior Authorization CPT/HCPCS Code Inquiry Tool This is a self-service tool to allow ambulance service providers, hospital, or physician office staff responsible for submitting prior authorization requests (PARs), to determine if the [...]

Skilled Nursing Facility and Swing Bed Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis. [...]

Hospital, CMHC, CORF/ORF and ESRD Facilities Quarterly Top Claim Errors

Do you struggle with your claim denials, rejections and return to provider (RTP) claims? Do you want to be proactive in preventing unnecessary errors? Join us in a review of top claim errors for your provider type based on recent data analysis. [...]

Let's Chat About Provider Enrollment

During this session, you’ll have the opportunity to ask questions about all aspects of provider enrollment. Answers will be provided by a panel of subject-matter experts. As this is a question-and-answer session, there is no presentation available.

NGSConnex Part B Claim Submissions and Claim Status Inquiry

Submitting Medicare Part B claims can be simple and efficient through the NGSConnex portal. During this webinar, we’ll show you how. We’ll review claim information including how to initiate a Part B claim, how to use the copy claim feature, [...]

NGSConnex: Claims and Medical Review Additional Documentation Requests

In NGSConnex, you have the ability to check the status of claims that have been selected for claim or medical review additional documentation requests (ADRs) in the last forty-five days for the provider selected. The ADR summary will show if [...]

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 [...]

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 & [...]

MLN Connects® Newsletter: April 24, 2025

MLN Connects® Newsletter: April 24, 2025 News Open Payments: Review Your Data by May 15 Medicare Shared Savings Program: Application Toolkit Materials MLN Matters® Articles Inpatient Psychiatric Facilities: Return to Provider Claims [...]

(CORRECTION) Some Claims Editing for Reason Code U537I, HH Claim Falls Outside of an HH Admission Period for the Same Provider

The CWF can only hold the 36 most recent periods of care for any beneficiary. CWF also contains the indicator of when the HH admission (NOA) was processed. This indicator allows CWF to determine whether an HH admission period is on file with [...]

Acute Care Hospitals: Advance Beneficiary Notice of Noncoverage (CMS-R-131 Form) for Outpatient Services

Acute care hospitals: Do you understand when and how to issue an Advance Beneficiary Notice of Noncoverage (ABN) for outpatient services? Join this session to learn more about the voluntary and mandatory ABN, three payment liability conditions, [...]

Illinois, Minnesota, Wisconsin

Member Name Group Email Aldrich, Elizabeth IPW (Independent Physicians of Wisconsin), Allen Family Practice ealdrich@ipw-offices.org Anderson, Benita Aurora Health Care Benita.Anderson@aurora.org [...]

Upcoming Annual Logon ID Recertification for Minnesota Region

Upcoming Annual Logon ID Recertification for Minnesota Region All users who access the FISS DDE system are required by the CMS to recertify their access annually. National Government Services will designate one state at a time to complete the [...]

Part A Top Reason Code changes

Part A Top Reason Code changes National Government Services, Inc. updates the Top Claim Errors on our website each quarter to ensure our Part A providers have the latest information on top claim errors including denials, return to provider, [...]

Stay of Enrollment

Stay of Enrollment The individual provider or authorized/delegated official of a group/facility agrees to adhere to all Medicare requirements when enrolling. CMS implemented a preliminary, interim status representing a pause in enrollment [...]

Stay of Enrollment

Stay of Enrollment The individual provider or authorized/delegated official of a group/facility agrees to adhere to all Medicare requirements when enrolling. CMS implemented a preliminary, interim status representing a pause in enrollment [...]

Prohibition of AI Assistant Usage for Recording Medicare Sessions

Prohibition of AI Assistant Usage for Recording Medicare Sessions National Government Services has observed a rise in attempts to use various AI assistants during NGS-hosted sessions. It is important to note that the CMS has a longstanding [...]

NGSConnex: Claim Status and Details, Remittance Advice and Submitting General Inquiries

We aim to help providers maximize the benefits of NGSConnex, particularly in claims review. NGSConnex provides an in-depth view of claims submitted to and adjudicated by National Government Services. During this webinar, we’ll highlight its [...]

Submitting a Medicare GME Affiliation Agreement

Submitting a Medicare GME Affiliation Agreement Table of Contents Submitting a Medicare GME Affiliation Agreement Jurisdiction K MAC (NGS) Jurisdiction 6 MAC (NGS) Submitting a Medicare GME Affiliation Agreement In [...]

NGSConnex: Initiating and Checking Status of Reconsiderations

Did you know that you can save time and money by requesting a reconsideration via NGSConnex? When you submit reconsideration requests electronically using NGSConnex, you no longer need to complete a form, copy documentation and waste time with [...]

FQHC MAO Supplemental Payment Calculation Form

Register Now for the Spring 2025 Virtual Conference

Register Now for the Spring 2025 Virtual Conference Don’t miss the opportunity to register for the 2025 Spring Part B Virtual Conference: Understanding Medicare Compliance for Part B Providers! Enhance your understanding and apply what you [...]

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 [...]

Helping Your Patients Stop Smoking

Helping Your Patients Stop Smoking Quitting Tobacco – Slips and Relapses Quitting smoking has health benefits at any age, no matter how long or how much you have smoked. If you slip or relapse, don’t be afraid to try and quit again. Each quit [...]

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: NGSMedicare.com Resources to Streamline CMS Enrollment Form Process

Provider Enrollment: NGSMedicare.com Resources to Streamline CMS Enrollment Form Process To eliminate the need for additional information requests, NGS offers a variety of provider enrollment resources on our website. These include valuable [...]

Provider Enrollment: Resources from NGSMedicare.com to Streamline the CMS-855A Application Process

Provider Enrollment: Resources from NGSMedicare.com to Streamline the CMS-855A Application Process To eliminate the need for additional information requests, NGS offers a variety of provider enrollment resources on our website. These include [...]

Prior Authorization for Certain Hospital Outpatient Department Services – The Exemption Process

In this webinar, the Exemption Team will compare the standard prior authorization review process to the exemption process with a focus on how to gain exemption status and remain exempt through the post pay claim review process.

Benefits of EDI

There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the [...]

Benefits of EDI

There are a number of advantages to enrolling and submitting claims online. Claims and other transactions submitted electronically process considerably faster than paper submission. For example, HIPAA-compliant electronic claims are held in the [...]

Benefits of Quitting Tobacco

Benefits of Quitting Tobacco Quitting tobacco use in any form is one of the most important actions people can take to improve their health. This is true regardless of their age or how long they have been using tobacco products. While quitting [...]

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.

Benefits of EDI

Portable X-Ray Cost Analysis Survey

Portable X-Ray Cost Analysis Survey NGS, in collaboration with other MACs, has launched a crucial initiative to assess and update transportation allowances for portable X-ray services, as mandated by the CMS every five years. Given that [...]

MLN Connects® Newsletter: May 1, 2025

MLN Connects® Newsletter: May 1, 2025 News Clinical Laboratory Fee Schedule Preliminary Gapfill Rates: Submit Comments by June 28 Compliance Acute Care Hospital Outpatient Services for Hospice Enrollees: Reduce Improper Payments [...]

Investigational Device Exemption Requests ‒ Renewals and Modifications

Investigational Device Exemption Requests ‒ Renewals and Modifications Effective for Category A and B IDE studies approved by the FDA on or after 1/1/2015, interested parties (i.e. study sponsors) seeking Medicare coverage must submit a [...]