CMS established the Comprehensive Error Rate Testing (CERT) program to monitor and report the accuracy of Medicare fee-for-service (FFS) payments. The CERT program measures the error rate for claims submitted to Medicare contractors. View t…
Submitting complete information for an overpayment request is important for accurate processing. This article provides reminders for submitting overpayment requests to First Coast.
First Coast has seen an increase in claims for drugs, hemophilia clotting factors, and skin substitutes that exceed the dollar amounts above $99,999.99. Effective for claims received on or after November 6, claims missing the required infor…
Effective for dates of service July 1, 2020, and after, hospital outpatient department (HOPD) providers will need to obtain prior authorization (PA) for panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy),…
These tips are based on questions posed regarding whether to bill an evaluation and management visit on the same day as a procedure or other services with modifier 25.