HHA Claim Edits Expanded
Independent and provider-based home health agencies (HHAs) will soon need to be more diligent about certain information listed on claims when billing for services provided to Medicare beneficiaries....
View ArticleMedicare Enrollment Requirement Extends to EPs Who Order/Refer
Physicians and non-physician practitioners (NPPs) who order and refer items and services for Medicare beneficiaries—even if that’s all they do— must be enrolled in the Medicare program, according to...
View ArticleMedicare Compare Updates Please Some, Not All
Now consumers can access all of Medicare’s Compare tools using the Quality Care Finder—a new tool that operates much like a one-stop shopping center for comparison information on hospitals, nursing...
View ArticleCMS Rescinds New Enrollment Requirements
Two new requirements recently added to the Medicare enrollment process may not be required after all. The Centers for Medicare & Medicaid Services (CMS) recently added to the CMS-855I enrollment...
View ArticleMLN Updates Medicare Claim Submission Guidelines
A September 2011 “Medicare Claim Submission Guidelines” fact sheet is now available on the Centers for Medicare & Medicaid Services (CMS) website. This Medicare Learning Network® (MLN) fact sheet...
View ArticleCMS Posts a List of Who Needs to Revalidate Enrollment
The Centers for Medicare & Medicaid Services (CMS) has posted on its website a downloadable file of all providers and suppliers who were mailed a revalidation letter. The list, which will be...
View Article2012 Annual Participation Enrollment Program Extended
To better allow physicians to manage the uncertainty of threatened Medicare fee reductions slated for the 2012 Medicare Physician Fee Schedule (MPFS), the Centers for Medicare & Medicaid Services...
View ArticleInternet PECOS Eases Medicare Enrollment
The Centers for Medicare & Medicaid Services (CMS) is introducing an Internet-based Provider Enrollment, Chain, and Ownership System (PECOS) application for providers and suppliers to speed review...
View ArticleSleep Medicine Docs Get Their Own Specialty Code
At long last, Medicare is giving physicians who specialize in sleep medicine a little recognition by giving them their own specialty code. The Centers for Medicare & Medicaid Services (CMS) makes...
View ArticleCMS Tweaks PECOS Enrollment Again
Signing up on the authenticated Internet-based Medicare Provider Enrollment, Chain, and Ownership System (PECOS) just got a little easier for providers and their staff. The Centers for Medicare &...
View ArticleNew Initiative Digs Gold Mine of Medicare Data
The Centers for Medicare & Medicaid Services (CMS) announced a new data and information initiative it says will be a key tool in the agency’s evolution from a fee-for-service based payer to a...
View ArticleNPPES Issues Resolved, NPI Registry Tip
Any latency and performance issues you may have experienced with the National Plan and Provider Enumeration System (NPPES) have been resolved, according to the Centers for Medicare & Medicaid...
View ArticlePECOS Easier to Use Than Ever, CMS Says
Based on provider feedback, the Centers for Medicare & Medicaid Services (CMS) has made several upgrades to the Provider Enrollment, Chain, and Ownership System (PECOS) to increase access to more...
View ArticleDon’t Let Medicare Revalidation Requirements Stop Cash-flow
By Delly E. Parham, AS, CPC When Medicare requests your provider to certify the accuracy of his or her existing enrollment information with Medicare revalidation, comply in a timely manner. If you...
View ArticleCMS Imposes First New Enrollment Moratoria Under Affordable Care Act
For the first time, the Centers for Medicare & Medicaid Services (CMS) is exercising its authority under the Affordable Care Act to impose temporary moratoria on new enrollments in Medicare,...
View ArticleAlready Using ACA Insurance? In 2015, It’s Automatic
If you signed up for health insurance coverage through the state and federal exchanges in 2014, you’ll automatically re-enroll next year. The U.S. Department of Health & Human Services (HHS) issued...
View ArticleFingerprinting Required for High Risk Providers, Suppliers
You might not remember, but back in 2011, the Centers for Medicare & Medicaid Services (CMS) published a rule that added a new security provision to the provider enrollment process. That provision...
View ArticleCMS Strengthens Abuse Prevention Safeguards
The Centers for Medicare & Medicaid Services (CMS) is using new Affordable Care Act authority to combat fraud, waste, and abuse in the Medicare system. The agency announced new safeguards to...
View ArticleEnrollment Verification Soon Required for Part D Prescribers
At first glance, a recent announcement by the Centers for Medicare & Medicaid Services (CMS) seems to suggest that prescribers of Medicare Part D drugs have been given a six-month reprieve from...
View ArticleNew Medicare Opt-Out Law Requires Physicians and Practitioners to Act
As a result of changes made by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), valid opt-out affidavits signed on or after June 16, 2015 will automatically renew every two years....
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