Tired of paper?
Secure Provider Online Tool (SPOT)
Did you know you can check claim status and find eligibility and benefits data online?
This special edition article reminds providers of the implementation of the all-inclusive population-based payment (AIPBP) payment mechanism for participating accountable care organization (ACOs). [SE17011]
Change request (CR) 10012 informs approved teaching hospitals about changes to the common working file (CWF) to bypass editing for certain blood services. [MM10012]
This article provides information regarding unsolicited/voluntary refunds; that is, monies received by Medicare not related to an open account receivable.
This information outlines the process for the 935 recoupment.
Change request (CR) 10000 provides billing instructions for ACP when furnished as an optional element of an annual wellness visit (AWV). [MM10000]
To determine if a claim was medically reviewed, providers should look at certain fields on the claim screen. [Provider Outreach and Education]
The Centers for Medicare & Medicaid Services (CMS) recently released change request (CR) 9916, which prepare Medicare’s claims processing systems for implementation of three new episode payment models for acute myocardial infarction, coronary artery bypass graft, and surgical hip and femur fracture treatment. [MM9916]
The Centers for Medicare & Medicaid Services (CMS) will establish two new Medicare secondary payer types for set-aside processes when a Medicare beneficiary receives an allocation of funds from a liability settlement, judgement, award, or other payment that is to be used to pay for a beneficiary’s future medical expenses. [MM9893]
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.
First Coast implemented a pre-payment edit on April 16, 2012, that applies to office visit E/M claims (codes 99201-99205 and 99212-99215) billed with the 24 modifier.
To correct claims returned for beneficiary name and number mismatch, take the following action. [CR 7260]
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]
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.
The interest period begins on the day after payment is due and ends on the day of payment. The new rate of 2.5 percent is in effect, from January 1, 2017, through June 30, 2017. [Publication 100-04, Chapter 1, Section 80.2.2]
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]
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.