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This edition includes information on crushing fraud, preventing E/M claim denials, a CMS listening session, and more.
CMS released a new version of Form CMS-460 (version 12/28). The former version (11/22) will no longer be accepted by the MACs after March 6, 2026. Read these instructions to complete the CMS-460 form.
Medical decision-making (MDM) is one of the key components used to determine the level of service for Evaluation and Management (E/M) coding. Since 2021, the American Medical Association (AMA) and CMS have emphasized MDM (or time) as the pr…
This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.
View this guide on how to use the Provider Enrollment Gateway.
Use these checklists to ensure you have met medical documentation requirements based on specific services.
The MEDPARD is a comprehensive listing of participating providers and suppliers who have agreed to accept assignment on all Medicare covered services. Read this article for links to JN directories for Florida, Puerto Rico, and the US Virgin…
This document was developed based on questions and answers posed during our webinars on the PA demonstration for ASC services.
Top denial/ partial denial reasons and high-level results are listed below from each round of Transitional Care Management (TCM) services TPE reviews that have been conducted thus far by Medical Review.
Are you sending hardcopy mail to submit your requests to First Coast? Did you know there are faster and easier ways to send your requests to us? Avoid the wait. Learn about the electronic options available for you to submit Part B financial…