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Did you know you can check claim status and find eligibility and benefits data online?
To correct claims returned for beneficiary name and number mismatch, take the following action. [CR 7260]
The Centers for Medicare & Medicaid Services (CMS) has issued a national coverage determination (NCD) to cover SET for beneficiaries with intermittent claudication (IC) for the treatment of symptomatic PAD. [MM10295]
Change request (CR) 10433 reestablishes all changes in CR 9911 to the Medicare remittance advice and Medicare summary notice by including qualified Medicare beneficiary (QMB) messages and reflecting $0 cost-sharing liability for the period beneficiaries are enrolled in QMB. [MM10433]
Review information from CMS about its action regarding recently expired Medicare legislative provisions.
This special edition article provides information on the next generation accountable care organization model’s benefit enhancement waiver initiatives and supplemental claim processing direction. This article was revised January 23 to revise the “Telehealth Expansion” portion of the article and to add Attachment A to the article. [SE1613]
Change request (CR) 10044 provides instruction to Medicare administrative contractors to implement two new benefit enhancements for performance year three of the next generation accountable care organization (NGACO) model. This article was revised January 23 to reflect the revised CR 10044 issued November 22, 2017. In the article, the CR release date, transmittal number, and the web address of the CR are revised. All other information remains the same. [MM10044]
This information outlines the process for the 935 recoupment.
To determine if a claim was medically reviewed, providers should look at certain fields on the claim screen. [Provider Outreach and Education]
The 2018 updated list of healthcare common procedure coding system (HCPCS) codes for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) jurisdictions is now available. [MM10416]
Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by the beneficiary.
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
This article reviews specific points that providers should consider regarding CCM guidelines, along with a link to a Medicare Learning Network® (MLN®) article that outlines the CCM guidelines in more detail.
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 2.625 percent is in effect, from January 1, 2018, through June 30, 2018. [Publication 100-04, Chapter 1, Section 80.2.2]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2016 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9410]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2017 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM9902]
The Centers for Medicare & Medicaid Services (CMS) recently issued the 2018 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee for service program. [MM10405]
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.