Railroad Medicare Provider News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Medicare Secondary Payer (MSP): Primary Insurance Information

In order for Palmetto GBA to appropriately determine the insurance company with primary responsibility, it is necessary to include the complete name (or properly abbreviated name) of the primary payer in the appropriate loops and segments when submitting your claims electronically. Please share with appropriate staff.


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Jurisdiction M Home Health & Hospice News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Update: Annual DDE Recertifications for JM Part A & HHH Distributed

Palmetto GBA has distributed DDE recertification notices to all active JM Part A and HHH DDE ID recipients. If you have not received your recertification email, please follow these steps to contact us so that your DDE access is not terminated.


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This post applies to: JM HHH

Jurisdiction M Part B News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Medicare Secondary Payer (MSP): Primary Insurance Information

In order for Palmetto GBA to appropriately determine the insurance company with primary responsibility, it is necessary to include the complete name (or properly abbreviated name) of the primary payer in the appropriate loops and segments when submitting your claims electronically. Please share with appropriate staff.


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Jurisdiction M Part A News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Inpatient Prospective Payment System (IPPS) Providers Diagnosis Related Group (DRG) Overpayment

Inpatient PPS claims submitted to Medicare on or after April 23, 2018 containing patient status codes 02 and 82 received full DRG payment in error instead of transfer reimbursement resulting in overpayment. A correction is tentatively scheduled for July 23, 2018. Once FISS has determined a correction it will be implemented and Palmetto GBA will initiate adjustments to collect against overpayments. Please share with appropriate staff.

Update: Annual DDE Recertifications for JM Part A & HHH Distributed

Palmetto GBA has distributed DDE recertification notices to all active JM Part A and HHH DDE ID recipients. If you have not received your recertification email, please follow these steps to contact us so that your DDE access is not terminated.


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Jurisdiction J Part B News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Counting Down the Days to ACE Smart Edits!

It’s only a couple of weeks until providers will be able to take advantage of the Palmetto GBA Advanced Communication Engine (ACE) smart edits. This system is available at no cost to you! Please communicate with your clearinghouse to ensure you are able to receive a full 277CA to include smart edits. Please share this reminder with your staff.

Medicare Secondary Payer (MSP): Primary Insurance Information

In order for Palmetto GBA to appropriately determine the insurance company with primary responsibility, it is necessary to include the complete name (or properly abbreviated name) of the primary payer in the appropriate loops and segments when submitting your claims electronically. Please share with appropriate staff.

Routine Foot Care Rejections for Required Information

An issue was identified on June 13, 2018, where routine foot care claims rejected for required information. Claims affected were rejected with Remark Codes MA130 – Your claim contains incomplete and/or invalid information, and no appeal rights are afforded because the claim is unprocessable; N253 – Missing/incomplete/invalid attending provider primary identifier; N324 – Missing/incomplete/invalid last seen/visit date. View the full claims payment issues log article for details about this issue and share this information with your staff.


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Jurisdiction J Part A News for 6/15/2018

Physicians: Are You Treating Men?

The month of June has been recognized as Men’s Health Month and is recognized around the country with screenings, health fairs, and other health education and outreach activities. Men’s Health Month can heighten awareness for preventable health problems and encourage early detection and treatment of disease among men. Please review and share this information with your staff.

Provider Minute: The Importance of Proper Documentation Video

This CMS video will help providers and physicians understand the need and importance of medical record documentation to support the services billed. Watch this video to learn more about what the CERT program has identified as leading documentation errors, and what providers and physicians can do to more thoroughly document the patient’s medical record. Please share with appropriate staff.

Targeted Probe and Educate Video

This video is about mistakes on Medicare claims and a new, simpler way to help you identify and correct them. To learn more about Targeted Probe and Educate (TPE), check out this five minute CMS video!

Inpatient Prospective Payment System (IPPS) Providers Diagnosis Related Group (DRG) Overpayment

Inpatient PPS claims submitted to Medicare on or after April 23, 2018 containing patient status codes 02 and 82 received full DRG payment in error instead of transfer reimbursement resulting in overpayment. A correction is tentatively scheduled for July 23, 2018. Once FISS has determined a correction it will be implemented and Palmetto GBA will initiate adjustments to collect against overpayments. Please share with appropriate staff.


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Railroad Medicare Provider News for 6/14/2018

Railroad Medicare Drugs of Abuse Testing Webcast: Recorded Presentation

Register now to access the recorded presentation of the June 12, 2018, Railroad Medicare webcast focused on the Medicare benefit for drugs of abuse testing. In our informative session, we explore Medicare benefit policies, medical necessity, and supporting documentation requirements. We also discuss how to respond to a Medical Review documentation request, provide helpful resources, and answer questions related to this topic. Please share this with your staff.


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Jurisdiction M Home Health & Hospice News for 6/14/2018

Help Us Improve/Enhance Our Website

We need your help to enhance the Palmetto GBA website. As a valued website visitor, only you know what information and tools are needed to assist you with your work. Your input is important! Please complete our short survey that’s sponsored by CMS and conducted by ForeSee Results. It represents your voice and provides us with detailed information on the types of services you like, want, or are dissatisfied with on the website. Please be specific in your evaluation of the website.

2018 Jurisdiction M (JM) Home Health Medicare Workshop Series – Winning with Medicare

Attention Home Health Providers! Palmetto GBA is pleased to announce our 2018 Home Health Workshop Series, Winning with Medicare. These workshops are designed for home health providers and their staff to equip them with the tools they need to be successful with Medicare billing, coverage and documentation requirements. Please review this information and share it with your staff.

2018 Jurisdiction M (JM) Hospice Medicare Workshop Series – Winning with Medicare

Attention Hospice Providers! Palmetto GBA is pleased to announce our 2018 Hospice Workshop Series, Winning with Medicare. These workshops are designed for hospice providers and their staff to equip them with the tools they need to be successful with Medicare billing, coverage and documentation requirements. Please review this information and share it with your staff.


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This post applies to: JM HHH

Jurisdiction M Part B News for 6/14/2018

Help Us Improve/Enhance Our Website

We need your help to enhance the Palmetto GBA website. As a valued website visitor, only you know what information and tools are needed to assist you with your work. Your input is important! Please complete our short survey that’s sponsored by CMS and conducted by ForeSee Results. It represents your voice and provides us with detailed information on the types of services you like, want, or are dissatisfied with on the website. Please be specific in your evaluation of the website.


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Jurisdiction M Part A News for 6/14/2018

Help Us Improve/Enhance Our Website

We need your help to enhance the Palmetto GBA website. As a valued website visitor, only you know what information and tools are needed to assist you with your work. Your input is important! Please complete our short survey that’s sponsored by CMS and conducted by ForeSee Results. It represents your voice and provides us with detailed information on the types of services you like, want, or are dissatisfied with on the website. Please be specific in your evaluation of the website.


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