Part B

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A step-by-step guide to getting started submitting electronic claims for providers

The following information outlines procedures related to getting started along with additional electronic features available to EDI providers.

Checklist: Chronic care management (CCM)

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for chronic care management (CCM) services.

Medicare secondary payer (MSP) billing

Read this article for more information on how to bill claims when Medicare is the secondary payer.

Modifier 25 fact sheet

Specific guidelines apply to the proper application and billing of modifier 25.

Checklist: Home health referrals

Medicare home health referrals must contain information in the medical record from the certifying physician and/or acute/post-acute care facility justifying the referral. Use this checklist to gain…

Checklist: Surgical services - Cataract extraction

This checklist is intended to provide health care providers with a reference for use when responding to medical documentation requests for surgical services: cataract extraction.

Completing the revalidation process

At some point, all Medicare providers/suppliers will be asked to revalidate Medicare enrollment information. Have you been sent a revalidation request? Not sure where to start? Avoid deactivation of…

Checklist: Home health referrals

Medicare home health referrals must contain information in the medical record from the certifying physician and/or acute/post-acute care facility justifying the referral. Use this checklist to gain…

Incident-to service guidelines

Medicare pays for services and supplies that are furnished incident to a physician’s or other practitioner’s services, are commonly included in the physician’s or practitioner’s bills, and for which…

Completing the revalidation process

At some point, all Medicare providers/suppliers will be asked to revalidate Medicare enrollment information. Have you been sent a revalidation request? Not sure where to start? Avoid deactivation of…