Reducing Unprocessable Claims

When claims are submitted with invalid, incomplete or incorrect information, our claims processing system will detect these errors and will reject claims as unprocessable. Our goal is to assist our providers in submitting claims correctly the [...]

National A/B Medicare Administrative Contractor Ambulance Provider/Supplier Coalition

National A/B Medicare Administrative Contractor Ambulance Provider/Supplier Coalition Attention Ambulance Providers In response to numerous and continued requests from the ambulance community, the AB MACs have put together a National AB MAC [...]

FQHC Example of a Per Visit Rate Calculation for MAO Supplemental Payments

National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition

National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition Attention Ambulance Providers In response to numerous and continued requests from the ambulance community, the AB MACs have put together a National AB MAC [...]

Medicare Part B Secondary Payer Post-Pay Overpayments

During this webinar, providers and office staff members will learn about the Medicare Part B overpayments and the appropriate steps for reporting Medicare Secondary Payer (MSP) overpayments. NGS MSP subject-matter experts will be on hand to [...]

Urgent Care

Urgent Care Please explain the concepts of split/shared and incident to E/M services in the urgent care setting. Answer: The urgent care setting is defined by CMS as a nonfacility setting. This means the split/shared concept does not [...]

Transitional Care Management

Transitional Care Management Please clarify responsibility for the TCM interactive contact. Can this be performed by a hospital-employed nurse prior to discharge? Answer: The provider who is billing the TCM service is responsible for the [...]

Time-Based Services

Time-Based Services Please define rules for using time to level-set a service. Answer: In both the office and observation/inpatient setting, the provider’s time is calculated based on pre-visit, intra-visit, and post-visit activities [...]