Targeted probe and educate (TPE) round results: Evaluation and management services – emergency department visits
Review the top denial / partial denial reasons and high-level results of evaluation and management services – emergency...
Articles
Article Type
Category
Submitting high dollar claims for single use vials
Read this article to learn more about submitting high dollar claims for single use vials.
Top claim denials / rejects
Use the left menu find tips to avoid common denials and claims rejections. Billing Medicare correctly the first time increases...
Fast facts: Skilled nursing facility (SNF) helpful hints
Read this article for helpful hints for SNF claim reviews by CERT.
Breakdown of Common Minimum Data Set (MDS) errors
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes...
Medical necessity requirements for skilled nursing facility (SNF) admissions
This questionnaire is intended to provide health care providers with a reference for use when screening a new patient for a SNF...
Credit Balance Status tool instructions
View this document to learn more about the Credit Balance Status tool.
Quarterly credit balance reports no longer required
Effective December 1, 2024, providers are no longer required to submit quarterly credit balance reports.
SNF overlap
You must determine if the services were provided during the covered period of the SNF Part A stay or after the benefits...