Payment issue affecting end stage renal dialysis services on type of bill 72X
Payment issue affecting end stage renal dialysis services on type of bill 72X.
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CERT Insider’s Guide – Part A Fourth Quarter 2025
Read the fourth quarter edition of the CERT Insider's Guide to learn more about the CERT program and the improper payment rate...
Public health emergency billing guidance for skilled nursing facilities (SNFs)
CMS allows programmatic waivers for impacted states under Section 1135 of the Social Security Act (SSA) for declared emergencies...
Ambulatory surgical center (ASC) prior authorization request (PAR) submission guidelines
View these submission guidelines for ASC prior authorization requests.
The SPOT User Guide: Section 6 - Appeals
Part A and Part B users may use the Appeals feature to submit an appeal request, and view appeals status / outcome.
This...
PC-ACE User Guide: Section 10 - Exiting PC-ACE including backup/restore
To exit the PC-ACE software program
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Click on the word File from the PC-ACE Main Toolbar and click on Exit.
You will be prompted...
New provider roadmap: Appeals
An appeal is a new and independent review of an initial determination of a claim.
Step 1: Determine whether you are submitting a
...
Breakdown of common Minimum Data Set (MDS) errors: Sections M - O & Z
The MDS is a tool used for implementing standardized assessment and for facilitating care management in skilled nursing homes...
CERT Insider’s Guide – Part A First Quarter 2025
Read the Part A first quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT...
The SPOT User Guide: Section 2 - Accessing SPOT
Enrollment references
All organizations must submit an enrollment form and each user must register in the Identity Management...