Posts Tagged ‘Provider’

CMS Processes Claims Despite PECOS Enrollment Status

Friday, July 2nd, 2010

Providers that did not get their Provider Enrollment, Chain and Ownership System (PECOS) enrollment applications approved by the July 6 deadline are getting a temporary reprieve. The Centers for Medicare & Medicaid Services (CMS) says it will not, for the time being, implement automatic rejections of claims submitted by providers that are not enrolled in PECOS. Until the automatic rejections are operational, submitted claims will continue to be reviewed and paid as usual.

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Billing Strategies

Monday, April 19th, 2010

by Rhonda Buckholtz, CPC, CPC-I, CPMA, CGSC, CPEDC, COBGC, CENTC

On any given day a medical practice has a large amount of stressors related to patient care. Providers place a great amount of attention on quality and in any given situation must adhere to multiple payer rules and regulations, and balance the best patient outcome based on those rules and regulations. Read more »

CMS Wants Provider Feedback

Monday, December 14th, 2009

The Centers for Medicare & Medicaid Services (CMS) is preparing to conduct the fifth annual Medicare Contractor Provider Satisfaction Survey (MCPSS). This survey offers Medicare fee-for-service (FFS) providers and suppliers an opportunity to give CMS feedback on their interactions with Medicare FFS contractors related to seven key business functions: Provider Inquiries, Provider Outreach & Education, Claims Processing, Appeals, Provider Enrollment, Medical Review, and Provider Audit & Reimbursement.

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HHS Allots $200M for Health Professions Training

Monday, August 17th, 2009

Approximately 8,000 students and credentialed health care professionals will get the financial backing they need for training by the end of 2010. Read more »

Cigna: 25 and 59 Require Documentation

Friday, May 1st, 2009

Providers submitting claims to Cigna: Make sure to read the private payer’s latest Professional Claims Code Editing and Documentation Requirements Guidelines. Effective April 27, the company now requires supporting documentation for some claims containing modifiers 25 and 59.

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CMS Eases Internet-based PECOS Security

Tuesday, April 14th, 2009

The Centers for Medicare & Medicaid Services (CMS) has made an important change to its Internet-based Provider Enrollment, Chain and Ownership System (PECOS) that will free up a lot of time for physicians and non-physician practitioners (NPPs). Read more »

Be Prepared When Calling CMS Customer Service

Monday, February 23rd, 2009

Very soon you won’t be able to make inquiries to the Centers for Medicare & Medicaid Services’ (CMS) interactive voice response (IVR) system or a customer service representative (CSR) without some very specific information.

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Final Rule Protects Providers’ Ethics

Monday, January 5th, 2009

The U.S. Department of Health and Human Services (HHS) issued a final rule Dec. 18, 2008 to ensure HHS funds do not support morally coercive or discriminatory practices or policies in violation of federal law. Read more »

Providers Remain Somewhat Satisfied

Friday, September 12th, 2008

The 2008 Medicare Contractor Provider Satisfaction Survey (MCPSS) indicates that Medicare health care providers continue to be moderately satisfied with services provided by Medicare fee-for-service (FFS) contractors.

On a scale of 1 to 6 (6 being completely satisfied), providers say overall contractor performance measures up to a 4.51 satisfaction level, according to the MCPSS survey. In 2007, the average score for overall contractor performance was 4.56, according to a report released by the Centers for Medicare & Medicaid Services (CMS). Carriers and Part B Medicare Administrative Contractors (MACs) received an average score of 4.35—somewhat lower than their counterparts. Read more »