Browse by Topic - JF Part A
Browse by Topic
Advance Beneficiary Notice of Noncoverage (ABN) - View an ABN overview, use, requirements, and resources.
Appeals - If dissatisfied with an initial claim determination, you have the right to request an appeal. There are many appeal levels and each level must be processed before proceeding to the next.
Cardiac and Pulmonary Rehabilitation Programs - View details regarding coverage provisions for CR and PR items and services, physician standards and limitations to the sessions that may be covered.
Claims - View claim submission assistance and general claims related information.
Compliance Program - View overview of Medicare compliance program requirements.
Dental - View information regarding dental services, coverage and exclusions.
Direct Data Entry (DDE) - DDE allows providers to check eligibility and claim status.
Documentation Requirements - View checklists to help providers submit appropriate documentation to Medicare.
Drugs, Biologicals and Injections - View guidance on drugs, biologicals and injections.
Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) - Access the Noridian DME Homepages, Latest Updates, contact information, Local Coverage Determinations (LCDs) and articles, and Jurisdiction Lists.
Electronic Data Interchange (EDI) - Connect with EDI regarding electronic claim submissions.
Emergencies and Disasters - In the event of a national or regional catastrophe or disaster, view resources.
Fraud & Abuse - View information regarding fraud, abuse, and the related process to report potential concerns.
Incentive Programs - View variety of CMS programs with financial incentives for providers.
Medicare Secondary Payer (MSP) - Term used to describe when another payer is responsible for paying a beneficiary's claims before Medicare pays. Access related MSP content from this page.
Modifiers - Modifiers can be two digit numbers, two character modifiers, or alpha-numeric indicators.
Noridian Medicare Portal (NMP) - Access General, Registration, End User, and Administrator function related guides and details.
Observation - What is/is not observation?, Observation time, Observation in CAH vs. PPS Facility, Outpatient to Inpatient/Inpatient to Outpatient, Observation over 48 hours.
Overpayment and Recoupment - This webpage defines the two situations in which overpayment occurs MSP (Medicare Secondary Payer) Overpayments and Non MSP Overpayments.
Preventive Services - Medicare pays for many preventive services to keep beneficiaries healthy. Preventive services can find health problems early, when treatment works best, and can keep them from getting certain diseases.
Remittance Advice (RA) - View information regarding how to read an RA (paper and electronic) as well as information on the reason and remark contains that appear on RAs.
Telehealth - Who can serve as an Originating Site and how to bill for the Originating Site Facility Fee, the payment methodology for those services, what geographical location that Originating Site must be located, an overview of what Part B services are eligible for Telehealth, which Part A facilities may bill for Distant Site services and additional resources.
Wound Care - View information regarding wound care related services.
CPT, ADA, and AHA End User License Agreement for Providers
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Copyright © 2018, the American Hospital Association, Chicago, Illinois. Reproduced with permission. No portion of the AHA copyrighted materials contained within this publication may be copied without the express written consent of the AHA. AHA copyrighted materials including the UB-04 codes and descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work without the written consent of the AHA. If an entity wishes to utilize any AHA materials, please contact the AHA at 312-893-6816
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