Site map
Topics
Claims & EDI
- How to file an appeal
- Appeals timeliness guidelines
- Submit appeals electronically
- Check status
- Reopenings / claim corrections
- Overpayments
- Helpful tips and guides
- Resources
- All appeals articles
- Billing / coding guidelines
- Modifiers
- MSP
- Beneficiary notices (ABN / BNI)
- Coordination of benefits
- Helpful tips & guides
- Service-specific billing
- All billing and coding articles
- Claim submission & status
- Processing issues
- Top claim denials / rejects
- Submission guidelines
- Helpful tips & guides
- Incentive programs
- Credit balance reporting
- All claims articles
Contact center
- IVR touch-tone convertor tool
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Enrollment
- New enrollment
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- Helpful tips and guides
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- All enrollment articles
FAQs
- Enrollment
- Claims / overpayments
- Billing / coding
- SPOT
- Review programs
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- Specialties / services
- Part A cost reports
Learning center
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Policy & review programs
- LCD interactive index
- Journey to LCD coverage
- LCD process
- CAC / open meetings (proposed LCDs)
- All LCD / medical policy articles
- Clinical trials
- Helpful tips & guides
- Resources
- CERT program
- Prior authorization program
- Targeted probe and educate (TPE)
- Medical review activities
- Additional review programs
- Medical documentation
- Helpful tips and guides
- Related resources
- All medical review articles
Provider audit & reimbursement (PARD)
- Cost reports
- Rates and reimbursement
- Audit
- Helpful tips
- Resources
- Related forms
- All cost reporting / audit articles
Specialties / Services
Specialties / Services
- Ambulance
- Ambulatory surgical center
- Anesthesia
- Cardiology
- Chiropractic services
- Clinical laboratory
- Dental services
- Drugs and biologicals
- Durable medical equipment
- End-stage renal disease
- Evaluation and management
- Global surgery
- Hospice / home health
- Hospital
- Independent diagnostic testing facility (IDTF)
- Inpatient rehabilitation facility
- Medicare diabetes prevention program
- Mental health services (CMHC/PHP)
- Oncology
- Ophthalmology
- Opioid treatment program
- Podiatry
- Preventive services
- Rehabilitation services
- Rural health / FQHC
- Skilled nursing facility
Tools & forms
- Login
- New user registration
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- User guide
- SPOT help desk
- System status
- Tips
- All SPOT articles
Appeals
Billing / coding
- Fee schedule lookup
- E/M interactive worksheet
- Modifier lookup
- MSP calculator
- ESRD calculator
- NCCI PTP lookup
Claims
- All claims forms
- ADR timeliness calculator
- Part A credit balance status
- Part A reason code lookup
- CMS-1500 interactive form
Compliance / review
EDI
- All EDI forms
- Secure Provider Online Tool (SPOT)
- TIBCO Gateway password change
- ERA reload request
- 5010 reject code lookup
- TIBCO Gateway password check
- HETS EDI enrollment tool
Enrollment
- All enrollment forms
- Enrollment Gateway
- Enrollment and revalidation status
- Application assistance tool
Overpayments