Wisconsin Physician Services (WPS), Medicare Administrative Contractor for the states of Indiana, Illinois, Kansas, Michigan, Missouri, and Nebraska, will be hosting a webinar on October 22, 2013 from 12:00pm – 1:00PM ET (11:00am – 12:00pm CT) on the Advance Beneficiary Notice of Noncoverage (ABN). Topics will include information on when the ABN is required, completing the ABN, and much more. To sign up for the webinar, click HERE and sign in or create a new user account if new. This is the site WPS is using for registration and is not affiliated with Gawenda Seminars & Consulting, Inc.

The J15 Part A Medical Review department performed a service-specific probe review on Resource Utilization Group Code (RUG) RUB10 in Kentucky from March through May 2013. Based on a 28.8 percent error rate and the percentage of medical necessity denials, this edit will be advanced to a complex edit review. For detailed results of the medical review, click HERE.

Based on Kentucky and Ohio CERT data, J15 Part A Medical Review will implement a service specific probe for 3-Day Inpatient Stays resulting in a SNF Admission. The service specific probe edit for bill type 11X will be implemented in Kentucky and Ohio. What to Send If you receive an Additional Documentation Request (ADR) from CGS, submit the requested medical record information within 30 days. Before you send the requested records, we suggest you double-check the accuracy of your submitted claim. Send the following documentation when responding to the ADRs, along with other supporting documentation. Please note: the documentation you

CMS is committed to ensuring a quality experience for health care providers who participate in the Medicare program. We can’t do this without input from you. If you are a Medicare Fee-For-Service (FFS) provider, practice manager or work on behalf of a Medicare FFS provider (such as a billing agency), please register now for an opportunity to tell CMS about the level of services that your MAC provides. You’ll need your national provider identifier (NPI) and provider transaction access number (PTAN) to sign up. If you work for a medical practice, you can list a group NPI and PTAN. MAC

Please join Wisconsin Physician Services (WPS) Medicare for a webinar on how to register and get recertified for C-SNAP access. C-SNAP is a FREE self-service portal that is a comprehensive, secured website to be used as your primary Medicare information source for patient eligibility, claim status information, and duplicate remittance notices. C-SNAP is available to you 24 hours a day, 7 days a week, with limited functionality outside of normal business hours, at no cost. This applies to providers in the states of Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska. The webinar will occur on October 8, 2013 from 2:00pm

Effective August 1, 2013, CGS is retiring the Local Coverage Determination (LCD) for Skilled Nursing Facility (L31892) for Kentucky and Ohio. CGS will continue to monitor utilization for medical necessity, but based on utilization data, an LCD is no longer needed at this time.

National Government Services is hosting a series of Ask-the-Contractor teleconferences (ACTs) for providers transitioning to the Jurisdiction 6 (J6) Medicare Administrative Contractor (MAC). The calls are open to all transitioning J6 Part A providers in Illinois, Minnesota, Wisconsin, and providers currently billing National Government Services under contractor 00450. The calls are also open to our current Home Health + Hospice (HH+H) and Federally Qualified Health Centers (FQHCs) providers. The Open Door Forum allows providers the opportunity to ask questions and share information during the session with your J6 MAC. This would be for non-private practice settings in the above mentioned states. Please

National Government Services is hosting a series of Ask-the-Contractor teleconferences (ACTs) for providers transitioning to the Jurisdiction 6 (J6) Medicare Administrative Contractor (MAC). The calls are open to all transitioning J6 Part B providers in Illinois, Minnesota, and Wisconsin. The Open Door Forum allows providers the opportunity to ask questions and share information during the session with your J6 MAC. This would be for private practices in the above mentioned states. Please note that preregistration is not required for these ACTs. However, if you plan to ask a question, please have the following information available for follow-up purposes: Name, Phone