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National Government Services Jurisdiction 6 Transition Information

Mon, 2013-05-20 12:32

CMS has awarded the J6 A/B MAC contract for the administration of the Part A and Part B Medicare fee-for-service claims in the states of Illinois, Minnesota, and Wisconsin to National Government Services, Inc. National Government Services Jurisdiction 6 MAC transition Web site has been launched. This is your comprehensive resource for all information and activities related to the J6 MAC transition.

Minnesota Part A transitions 8/10/2013

Illinois, Minnesota, and Wisconsin Part B transitions 9/7/2013

CHANGE NOTIFICATION TO REIMBURSEMENT POLICIES

Thu, 2013-02-28 09:55

For claims with for dates of service on or after May 20, 2013, Travel allowance services for collection of a Lab Specimen reported with HCPCS codes P9603 and P9604 are not eligible for separate reimbursement even when reported with modifier 59. The Laboratory and Venipuncture Services reimbursement policy will also be updated to reflect this change.

Improper Payments to Providers for Incarcerated Beneficiaries

Wed, 2012-12-19 14:25

The Office of Inspector General (OIG) of the Department of Health and Human Services advised in the 2013 OIG Work Plan that they would be reviewing Medicare payments for Incarcerated Beneficiaries. Audits conducted by the OIG have resulted in overpayments to providers across the country, including those serviced by National Government Services. As a result, CMS has charged National Government Services to begin the process of recouping identified overpayments. The first series of overpayment adjustments have generated. Overpayment letters will begin to be mailed on Monday, December 10.

Payments for Alien Beneficiaries Unlawfully Present in the United States on the Dates of Service

Wed, 2012-12-19 14:22

The Office of Inspector General (OIG) of the Department of Health and Human Services advised in the 2013 OIG Work Plan that they would be reviewing payments for Alien Beneficiaries Unlawfully present in the United States. Audits conducted by the OIG have resulted in overpayments to providers across the country, including those serviced by National Government Services. As a result, CMS has charged National Government Services to begin the process of recouping identified overpayments. The first series of overpayment adjustments have generated.

Prior Authorization Request Process for 2012 Molecular Pathology Codes

Mon, 2012-07-23 17:00

When there is a new code for the molecular pathology test being ordered providers must request prior authorizations for the new code (e.g. 81200, 81205) supported by the codes billed prior to January 2012 as "stacked" codes (e.g. 83909, 83891) for the test being ordered, including the number of units of each of the stacked codes. The Department will authorize one unit of the new code. When possible, an appropriate price for a new code will be established on the Consolidated Laboratory Fee schedule.

Changes to Prior Authorization Process for Laboratory Procedures

Mon, 2012-07-23 17:00

Effective July 1, 2012, requests for prior authorization for laboratory procedures, including genetic testing are to be submitted through the medical administrative services organization (ASO), Community Health Network of CT (CHNCT). Prior authorization requests will no longer be accepted by HP as of July 1, 2012.

Consolidated Laboratory Fee Schedule Update

Sun, 2012-01-15 16:00

Effective for dates of service January 1, 2012 and forward, the Department of Social Services will incorporate the 2012 HCPCS changes (additions, deletions and description changes) to its Consolidated Laboratory Fee Schedule.

Molecular Pathology Codes

Consolidated Laboratory Fee Schedule Update

Sun, 2012-01-15 16:00

Effective for dates of service January 1, 2012 and forward, the Department of Social Services will incorporate the 2012 HCPCS changes (additions, deletions and description changes) to its Consolidated Laboratory Fee Schedule.

Molecular Pathology Codes

Section 935 Recoupment Basics

Fri, 2010-05-28 08:01
Recoupment is the act of recovery by a Medicare contractor—such as National Government Services or by a recovery audit contractor (RAC)—of any outstanding Medicare debt by reducing present or future Medicare remittance advice payments and applying the amount withheld to the indebtedness. It applies to the recovery of funds for all Medicare Part A and Medicare Part B claims for which a demand letter is issued.

National Government Services Launches Enhanced Medical Policy Center Search Function

Fri, 2010-05-28 08:04

National Government Services has finalized several elements of its enhanced Medical Policy Center (MPC) search function on the NGSMedicare.com Web site. The following improvements are effective immediately:

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