Claims
Hospice: New requirement for physicians who certify patient eligibility
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or…
Resolving claims overlapping a skilled nursing facility (SNF) stay
Is your facility receiving denials for a claim overlapping a skilled nursing facility (SNF) stay? Claims overlapping with a skilled nursing facility (SNF) stay can occur for several reasons. This…
Critical access hospital (CAH) method II professional reassignments
CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment isn’t in PECOS. Watch the on-demand learning video, "CAHs Method II Professional Reassignments,"…
Method II critical access hospitals: Reprocessing certain claims with reassigned billing rights
Breaking news for critical access hospitals (CAHs): CMS has directed MACs to immediately turn off reason codes 31006 and 31007 to give providers time to submit all method II reassignments to their…
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Prevent errors on your OTP claims
Learn about the top errors First Coast has identified for Opioid Treatment Program (OTP) claims and how you can prevent the errors on your claims.
Tips to prevent claim adjustment reason code (CARC)s 54NCD or 53NCD
Read this article for tips to prevent claim adjustment reason code (CARC)s 54NCD or 53NCD.
Tips to prevent claim adjustment reason code (CARC) CO 22
CARC 22 - This care may be covered by another payer per coordination of benefits. This denial was received because Medicare records indicate that Medicare is the secondary payer.
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Claims processing codes: Find definitions of reason and remark codes
There could be several reasons why your claim was denied or otherwise did not process successfully. Use these available resources to identify claims processing codes.