Allowing electronic submission of medically denied cancel claims
To determine if a claim was medically reviewed, providers should submit the requests correctly.
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End stage renal disease (ESRD) billing reminders and quarterly updates
Review this article to view common billing errors and how to review quarterly ESRD updates.
Resolve claim return reason code 34963 for outpatient therapy services
Are you providing outpatient therapy services on institutional claims and receiving reason code 34963 indicating the attending...
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code...
Understanding radiopharmaceutical fee schedule amounts and billing expectations
Read this clarification regarding how radiopharmaceutical payment limits should be interpreted and how providers are expected to...
First Coast supports Part B billing awareness during the month of June
Keep the momentum going -- navigate Part B post-payment claim scenarios! Attend the Medicare Navigator Part B Billing series and...
Crossover claims: Supplemental insurance and Medigap plans
Read this article for more information on claims being crossed over to supplemental insurance and Medigap plans.
Cardiac and pulmonary rehabilitation programs
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR)...
New high-cost cell-based gene therapy drug Encelto approved for use in the ambulatory surgical center (ASC) setting
Medicare approved the groundbreaking new cell-based gene therapy drug, Encelto, for use in the ambulatory surgical center...