Fast facts: CERT claim sampling and review process
Read this article for information about CERT claim sampling and the review process.
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First Coast supports compliance awareness during the month of March
Our Medicare Navigator Program is back with webinars focused on supporting providers to successfully navigate Medicare program...
Fast facts: CERT documentation submission
Read this article to review some helpful information about the CERT program responding to additional documentation requests...
Cognitive assessment and care plan services
If your patient shows signs of cognitive impairment during a routine visit, Medicare covers a separate visit to more thoroughly...
Billing instructions for implanted prosthetic devices with HCPCS code C9899: Reason code 32354
To promote consistency in the claim submission process, follow these instructions when billing HCPCS code C9899.
Tips on how to avoid billing a duplicate claim
Duplicate claim denials continue to be one of the top billing errors. Duplicate submission of Medicare claims causes an increase...
Medicare & Veteran Affairs: Adjustments for duplicate claims
CMS entered into an agreement with the Department of Veterans Affairs (VA), which allows First Coast to recover duplicate...
Post-payment service-specific reviews
Medical review of claims helps to ensure that Medicare pays for services that are covered, correctly coded, and medically...
Targeted probe and educate (TPE)
TPE is one process that a MAC can utilize when providers are selected by medical review.
Skilled nursing facility (SNF) 5-claim probe and educate (P&E) review
View this article for information concerning requirements of change request 13164.