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This checklist is intended to provide health care providers with a reference for use when responding to additional documentation requests for transitional care management (TCM) services.
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original Medicare.
Access all of our self-service tools here.
Review the top denial / partial denial reasons and high-level results of evaluation and management services - initial inpatient care visits and subsequent inpatient care visits TPE round results.
Find the latest Electronic Data Interchange (EDI) news, software updates, forms, and companion documents and learn how to begin submitting your claims electronically.
Read the Part A first quarter edition of the CERT Insider's Guide to learn more about claim errors assessed during the CERT review process and ways to mitigate these errors in the future.
Find the latest Medicare news identified specifically for providers of cardiology services as well as helpful information, tools, and links to CMS resources pertaining to this specialty.
Review minutes from the Part A Provider Outreach and Education Advisory Group (POE-AG) meeting for Florida/USVI.
Read this article to learn more about the CERT awareness month campaign focusing on responding to CERT documentation requests.
Details on submitting the credit balance report, submission deadlines, and a tool to check credit balance status.