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A compliance program can identify, help prevent, and correct inappropriate activities of employees and/or billing companies.

A compliance program can identify, help prevent, and correct inappropriate activities of employees and/or billing companies.

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.

This edition includes information on crushing fraud, opioid use disorder, the Medicare participating physician agreement form expiration, and more.

This edition includes information on crushing fraud, opioid use disorder, the Medicare participating physician agreement form expiration, and more.

There are a few scenarios that exist for denial reason code CO 97, as outlined below. Please review the associated remittance advice remark code (RARC) noted on the remittance advice for your claim…

Telehealth services substitute for an in-person visits and involve two-way, interactive technology permitting communication between the practitioner and patient. Recent legislation authorized an…

View this information on the free software provided by CMS for viewing and printing electronic remittance advice (ERA).

CMS is delaying the start date for the PA demonstration for certain services provided in ASCs and will be implementing the demonstration in two phases. For more information on the delayed…

View this special edition update on processing of Medicare claims impacted during the government shutdown as well as the 2026 ESRD PPS final rule.