The article reports that, effective May 1, 2013, the U.S. Centers for Medicare & Medicaid Services (CMS) will deny claims when the ordering or referring provider is not enrolled in Medicare. The CMS will deny Part B Durable Medical Equipment (DME) and Part A Home Health Agency (HHA) ...
CMS has not yet decided when it will begin to reject claims if an ordering/referring provider does not have a Provider Enrollment, Chain and Ownership System (PECOS) record. CMS will give providers ample notice before claim rejections begin. Change Request (CR) 6421 implements system edits to ...
CMS Delays Edits to Deny Claims When Ordering/Referring Provider Not Enrolled in Medicare and Issues Proposed Rule on Enrollment RestrictionsJoan PolacheckMonica Wallace
CMS has been participating in public and private partnerships in addressing costs and quality of care. This study addresses alternative methods of profiling physician referring patterns for selected high volume imaging tests.Levy, JRTI International...
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