Conditional payment requests for MSP claims
Providers may file a Medicare secondary payer (MSP) claim and request a conditional payment for a Medicare-covered service when...
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MSP value codes and payer codes
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary...
Requesting Medicare secondary payer conditional payments
Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under...
Claims and appeals for CPT 93010 performed in emergency room setting
Please review this article regarding appeals received for CPT 93010 (electrocardiogram report) and the use of modifier 77.
Advance payment – Part B only
View this article for information about Part B advance payment submissions.
Positron emission tomography (PET) for oncologic conditions: Modifier usage
The appeals department is receiving appeals regarding the incorrect usage of modifiers associated with PET scans. Read this...
Appealing new patient denials
Learn how to submit an appeal for evaluation and management services denials because the new patient did not meet new patient...
New Part A Medicare redetermination and clerical error reopening request form available now
Make sure to access our new and improved form which simplifies the submission of your Part A redeterminations.
New Part B Medicare redetermination and clerical error reopening request form
Make sure to access our new and improved form to submit for your Part B redeterminations.
Appeal tips: Documentation to include with your Part B redetermination request
Learn what documentation to include when submitting a Medicare Part B appeals request.