PROVIDERS BILLING PAPER CLAIMS USING THE CMS 1500 CLAIM FORM WITH ONLY THE SCREENING CODES MUST NOW SUBMIT THE KM-3 CLAIM FORM WITH ALL DETAIL INFORMATION. EDUCATIONAL EDITS (517 AND 518 OR HIPAA ADJUSTMENT REASON CODE 16 FOR 835 ELECTRONIC RA) CURRENTLY APPEAR ON ANY ELECTRONIC AND HARD COPY...
Providers should submit an adjustment for APRN claims that did not have the required Designated Physician's NPI included in the appropriate location on the previously paid claim. This can be done by paper using the 213 Adjustment Form or electronically via the 837P adjustment format. The Designate...
Proposal.The President's budget seeks legislation that would provide federal reimbursement to state Medicaid programs for the Medicare Part B premium costs of QI-1s based on the FMAP, thereby requiring a state share. HHS estimates that the proposal would save $200 million in FY2009, and $200 ...
The Centers for Medicare & Medicaid Services (CMS) has increased oversight of MA plans, particularly around the accuracy of risk adjustment coding and the documentation of diagnoses that determine reimbursement rates. Healthcare providers who work with Medicare Advantage plans should be aware of the ...