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 [...]

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 [...]