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Claims are introduced into PC-ACE by either entering them manually or by importing them from an external source. The claim import method is ideal for facilities that maintain their claims in an upstream claims management system.
View TPE round results for rehabilitation services outpatient (KX modifier).
Review the top denial / partial denial reasons and high-level results listed below from each round of JN ESRD TPE reviews.
Learn how to submit a provider enrollment appeal in the form of a corrective action plan or reconsideration request.
Use these self-service tools and forms related to claims.
Effective July 1, 2026, new billing instructions apply related to no longer submitting the AX modifier and hemodiafiltration and AKI claims.
Read this article for guidance for the treatment of Medicare Part C days in the calculation of a provider's Medicare disproportionate share hospital adjustment.
Use this help guide for the enrollment application status tool. This versatile application allows you to check the status of your enrollment application in the Medicare program in three ways.
This briefly identifies the two methods used to determine the disproportionate share as well as the supplementary security income updates.
View details regarding specific modifiers including tips, decision flowcharts, and educational information.