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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. View details

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

Dental - View information regarding dental services, coverage and exclusions

Direct Data Entry (DDE) - DDE allows providers to check eligibility and claim status. View details

Documentation Requirements - View checklists to help providers submit appropriate documentation to Medicare

Drugs, Biologicals and Injections - View guidance on drugs, biologicals and injections

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. View details

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. View details

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. View details

Remittance Advice (RA) - View information regardng 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. View details

Last Updated Mar 09, 2018

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