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A self-service feature is available via the Part B interactive voice response (IVR) that allows providers / customers to request telephone reopenings on certain claims via the IVR.

In this special edition article, CMS stresses the importance of staying informed of all CMS national inpatient hospital policy and national and local coverage determinations regarding making a…

This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.

This edition includes information on critical access hospitals, seasonal flu vaccine pricing for 2025-2026, nursing home care compare updates, and more.

Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.

Before you request a redetermination on a denied claim, review these tips to avert delays in payment and save some valuable time.

We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.

Medicare Advantage (MA) supplemental wrap-around payments -- reason code 37098 for federally qualified Health centers (FQHCs) that have a written contract with an MA organization.

Effective August 31, 2023, documentation is required for claims submitted with modifier 52. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on…

Effective August 31, 2023, documentation is required for claims submitted with modifier 22. To avoid claim rejects and future appeals due to incorrect claim submissions, we’re providing guidance on…