ASCA: Must an Administrative Simplification Compliance Act waiver be mailed or can it be faxed?

ASCA: How will I know the outcome of my Administrative Simplification Compliance Act waiver request form?

ASCA: If my Administrative Simplification Compliance Act Waiver Request is denied, what will happen to my paper claims?

ASCA: How will the Administrative Simplification Compliance Act enforcement review affect me as a “small provider/supplier?” Will I be required to submit claims electronically?

ASCA: What kind of supporting documentation should I attach to my Administrative Simplification Compliance Act Waiver Request?

37098

Avoiding/Correcting This Error Verify billing and, if appropriate, correct and return the claim. Related Content Billing for FQHC MAO Plan Supplemental Payment (PPS Providers) CMS Internet-Only Manual 100-04, Medicare Claims Processing [...]

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

39929

Avoiding/Correcting This Error Verify the line level rejection information to determine the rejection for each of the lines of the claim in question. Resubmit as appropriate. Line level reason code(s) appear on the right view of claim page two [...]

W7088

Avoiding/Correcting This Error Each FQHC PPS claim must be billed with a qualifying visit code, and associated line-item charges, along with all other FQHC services furnished during the encounter. A qualifying visit code is the code that [...]

W7089

Avoiding/Correcting This Error Payment for a FQHC encounter requires a medically necessary face-to-face visit. Each FQHC specific payment code (G0466-G0470) must have a corresponding service line with a HCPCS code that describes the qualifying [...]

W7089

Avoiding/Correcting This Error Payment for a FQHC encounter requires a medically necessary face-to-face visit. Each FQHC specific payment code (G0466-G0470) must have a corresponding service line with a HCPCS code that describes the qualifying [...]

U5065

Avoiding/Correcting This Error Check/verify the beneficiary's entitlement dates in the CWF. A Medicare beneficiary, or their authorized representative, may have requested a new MBI. Verify eligibility and MBI number, correct and return the claim.

31836

Avoiding/Correcting This Error Verify billing and, if appropriate, correct and resubmit the claim for payment. Related Content MLN® Booklet: How to Use the PFS Look-up Tool

32078

Avoiding/Correcting This Error Ensure the appropriate revenue code(s) and HCPCS/CPT code(s) are reported on the claim and each claim line contains the correct service date. Verify the information billed and PF9 to resubmit. Related [...]

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim.   To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

38312

Avoiding/Correcting This Error If appropriate, correct and resubmit a new claim.   To prevent this error on future claims: Ensure you have received all charges from all departments and that no claim has been submitted for the same DOS [...]

32243

Avoiding/Correcting This Error Review the claim and either update the charges or remove the line containing zero or blank charges. Return the claim for processing. 

32402

Avoiding/Correcting This Error Verify HCPCS code using the FISS DDE Inquiries HCPCS file (option 14) to determine the allowable revenue codes based upon the date of service. Verify billing and, if appropriate, correct the claim using the [...]

W7088

Avoiding/Correcting This Error Each FQHC PPS claim must be billed with a qualifying visit code, and associated line-item charges, along with all other FQHC services furnished during the encounter. A qualifying visit code is the code that [...]

56900

Avoiding/Correcting This Error Regularly access claims in status locations SB6001, SB6098, or SB6099 to obtain a listing of claims for which records have not yet been received by the MAC (Medical Review Department). Look for information on the [...]

C7010

Avoiding/Correcting This Error If services are unrelated to hospice stay, resubmit with condition code 07 (treatment of nonterminal illness for hospice patient). Verify hospice enrollment prior to claim submission by reviewing the CWF, the [...]

39934

Avoiding/Correcting This Error Review each line level denial reason code(s). Follow the steps provided in that line level reason code narrative. Line level reason code(s) appear on the right view of claim page two (MAP171D). In order to access [...]

38200

Avoiding/Correcting This Error Always verify the status of a submitted claim before submitting another claim. Verify claim status using the IVR system, FISS/DDE or the NGSConnex online portal. Per CMS mandate, PCC representatives are not [...]

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 [...]

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 [...]

34963

Avoiding/Correcting This Error Verify billing and, if appropriate correct and return the claim. Online providers should press PF9 to restore the claim. Related Content New Fiscal Intermediary Shared System Consistency Edit to Validate [...]

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 [...]

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.

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.

Modifier Lookup Tool Top

Modifier Lookup Tool This tool provides information for most procedure code modifiers used by Medicare. Enter the four required fields and be presented with details. Disclaimer: Existence of a valid procedure/modifier combination does not [...]

Modifier Lookup Tool

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 & [...]

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: 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.

SNF 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 [...]

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 [...]

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 [...]

Acute Care Hospitals: A Peek Inside the Three-Day Payment Window

To prevent return to provider (RTP) claims, join us for this webinar in which we will review the three-day payment window policy (aka bundling, preadmission services, diagnosis-related group (DRG) window, 72-hour rule) and provide billing [...]

Part A Fundamentals of Medicare

Provide an understanding of the fundamentals of the Original Medicare Program.

Care Management: Principal Care Management Services

As part of a continued series, we’re raising awareness of the benefits of care management. During this webinar, we’ll focus on principal care management services for patients with a single chronic condition. We’ll provide resources and share [...]

Care Management: Chronic Care Management

As part of a continued series, we’re raising awareness of the benefits of care management. During this webinar, we’ll focus on chronic care management services for patients with chronic conditions. We’ll share resources and review proper [...]

Care Management: Transitional Care Management

As part of a continued series, we’re raising awareness of the benefits of care management. During this webinar, we’ll focus on transitional care management services for Medicare patients. When a physician discharges a Medicare patient from an [...]

Care Management: Cognitive Assessment

As part of a continued series, we’re raising awareness of the benefits of care management. During this webinar, we’ll focus on cognitive assessment, which is a separate service that may be billed for patients when you have recognized potential [...]

Care Management: Advanced Care Planning

As part of a continued series, we’re raising awareness of the benefits of care management. During this webinar, we’ll focus on advanced care planning (ACP) services for patients with chronic conditions. We’ll share resources and review proper [...]

Care Management: Behavioral Health Integration and Psychiatric Collaborative Care Management

As part of a continued series, National Government Services is raising awareness on the benefits of care management. During this webinar, we’ll discuss behavioral health integration and psychiatric collaborative care management. This service [...]

MLN Connects® Newsletter: July 24, 2025

MLN Connects® Newsletter: July 24, 2025 News 2025 Quality Conference Highlights July 2025 Provider Specific Data for Public Use Files Compliance Remote Patient Monitoring: Use & Bill Correctly Publications & Multimedia [...]

Medicare Part B Top 10 Claim Denials

Each quarter, we host this webinar to address the top claim denials we receive. We research and identify common errors and offer solutions to prevent them, which has effectively reduced errors. There will be time following the presentation to [...]

Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application

Institutional Providers: Revised CMS-855A Version (09/24) Medicare Enrollment Application  Available now is the revised CMS-855A (09/24) paper application that includes a section for SNF to comply with the 2023 Final rule in reporting [...]

APPLICATION STATUS: Where can I find the status of a submitted application?

CMS-855I: How do I complete a reassignment?

CMS-855I: Who needs to sign the CMS-855I for a reassignment?

DETERMINATION LETTER: Where are the determination (approval/denial) letters sent?

DETERMINATION LETTER: Where are the determination (approval/denial) letters sent?

PECOS: I received an email to sign an application; how do I do this?

PECOS: I received an email to sign an application; how do I do this?

PECOS: In PECOS, how do I know what enrollment information Medicare currently has on file for a provider or supplier?

PECOS: In PECOS, how do I know what enrollment information Medicare currently has on file for a provider or supplier?

PECOS: In PECOS, how do you find an enrollment to submit an application?