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  • Posting Date: 07/17/2025
    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.

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  • Posting Date: 07/17/2025
    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 [...]

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  • Posting Date: 07/17/2025
    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. 

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  • Posting Date: 07/17/2025
    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 [...]

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  • Posting Date: 07/17/2025
    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 [...]

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  • Posting Date: 07/18/2025
    CERT Awareness Week Three – Verify Your Medical Records Correspondence Address

    CERT Awareness Week Three – Verify Your Medical Records Correspondence Address The Part A, Part B, DME, home health and hospice and RRB MACs are working together to promote the importance of complying with CERT documentation requests. This is [...]

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  • Posting Date: 07/21/2025
    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 [...]

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  • Posting Date: 01/05/2024
    Intensive Outpatient Program

    Intensive Outpatient Program Table of Contents IOP vs. Partial Hospitalization Program Provider Types Eligible to Provide IOP Medicare Beneficiary Eligible for IOP Services Active Treatment and Treatment Plan Covered IOP Services [...]

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