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When a medical reviewer contacts the provider requesting to submit an attestation statement or signature log to authenticate a medical record, the provider must submit the attestation statement or signature log within 20-calendar days.
The National Correct Coding Initiative (NCCI) was developed to promote national correct coding methodologies and to control improper coding leading to inappropriate payments. Read this article to learn more about NCCI and other coding edits…
Cotiviti GOV Services has been awarded the region three recovery audit contract. Read this article to learn more.
Make sure to provide your correct PTAN in the proper format when contacting us for any claim-related inquiries. PTANs that have double zeroes as a prefix (00XXXXX) should be provided with those zeroes, followed by the remaining digits. If y…
This article has resources available for verifying the status of your CERT review.
Effective August 31, 2023, documentation is required for claims submitted with modifier 52. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on how to properly submit a claim when applyi…
This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.
We added a YouTube video on Medical Review best practices to prevent unnecessary “non-response” denials. Let us know what you think by selecting the Like button and don’t forget to subscribe to our YouTube channel. Thanks for watching!
Urological supplies are covered as part of the Prosthetic Device benefit as outlined in the Social Security Act § 1861(s)(8).
CMS has issued a final NCD for FDA-approved Pre-exposure Prophylaxis (PrEP) using antiretroviral drugs to prevent HIV infection. Note: Local contractor pricing has been revised for code J0750. Please review the article for current pricing.