Tips to prevent claim adjustment reason code (CARC) CO/PR B7
You received this denial for one of the following reasons: 1) the date of service (DOS) on the claim is prior to the provider’s...
What is the difference between LCDs and NCDs?
Local coverage determinations (LCDs) for a specific jurisdiction are developed by the MAC assigned to that jurisdiction. First Coast is the MAC for Florida, Puerto Rico, and the U.S. Virgin Islands. Although the majority of coverage determinations are local, in certain cases, CMS may develop a national coverage determination (NCD) that is applicable to all jurisdictions.
Tips to prevent claim adjustment reason code (CARC) CO 50/PR 50
To increase the number of claims that successfully process and enhance cash flow, we are providing you with the top reasons...
Can multiple users from the same organization use one IDM account? If an employee leaves the organization, can another employee use the IDM account?
No, users are not permitted to share accounts. Each user much register for their own account.
Will I lose my SPOT access if I become inactive?
No, the SPOT user will need to do a password reset.
When is it acceptable to collect the deductible from the beneficiary?
When assignment is accepted, Medicare Part B recommends:
How is the Medicare Part B annual deductible applied to payment?
For each calendar year, a certain cash deductible exists that must be met before payment may be made by Medicare.
- The deductible for 2025 is $257.00.
Patient expenses are applied toward the deductible based on incurred, rather than paid expenses, and are based on Medicare allowed amounts. Non-covered expenses do not count toward the deductible.