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Understanding applicable Medicare coverage criteria for medical necessity and documentation guidelines for healthcare services is extremely important for the accurate and timely processing and payment of claims. Partnering with Medicare can…
View requirements for enrolling as a clinical psychologist with Medicare.
Read this article for tips on how to prevent reject reason code U5233.
Hospital outpatient departments (OPDs) who demonstrate compliance with Medicare coverage, coding, and payment rules related to prior authorization (PA) may be eligible for exemption. This exemption would remain in effect for a 12-month peri…
Read this article for tips to prevent claim adjustment reason code (CARC)s 54NCD or 53NCD.
A list of the EDI and SPOT enrollment forms.
View these webinar recordings on all things SPOT-related, including features and functionality, eligibility and MBI lookup, submitting electronic claims, and more.
How to find policy indicators such as global days for a service, relative value units (RVUs) for a particular code, and more.
Learn how to take advantage of the features of our exclusive E/M interactive worksheet and find the code that best represents the level of evaluation and management services (E/M) furnished during a patient’s visit.
CMS has designed several initiatives to eliminate disparities in health care quality and access so that all Medicare patients can achieve their highest level of health. This page highlights resources you can use to help support this initiat…