When not to show patient paid amounts on claims
First Coast has been made aware of complaints by beneficiaries being required to pay for services up front. This article...
Skilled Nursing Facilities (SNFs): Provider enrollment guidelines
Read this article for new guidelines for Skilled Nursing Facilities (SNFs). Updated to add extended due date for revalidations.
Conditional payment requests for MSP claims
Providers may file a Medicare secondary payer (MSP) claim and request a conditional payment for a Medicare-covered service when...
MSP value codes and payer codes
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary...
Reciprocal billing and fee-for-time compensation arrangements (formerly locum tenens arrangements)
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same...
Leqembi for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and...
Requesting Medicare secondary payer conditional payments
Conditional payments are Medicare payments for Medicare covered services for which another insurer is primary payer, made under...
Split or shared E/M guidelines: Medicare Claims Processing Manual updates
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
Multiple procedure payment reduction
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of...
New Fiscal Intermediary Shared System (FISS) consistency edit to validate attending physician NPI
Effective April 1, CMS implemented a new consistency edit to validate the attending physician NPI. Claims are returning with...