Cigna Government Services invites you to participate in an Ask-the-Contractor Teleconference (ACT) specifically focused on the new claims-based data collection reporting requirement and changes to the manual medical review process for outpatient therapy services. The teleconference is scheduled for Thursday, May 23, 2013, from 9-10:30 a.m. CT/10-11:30 a.m. ET. No pre-registration is necessary. To join the teleconference, please click HERE.

Noridian will become the Medicare Administrative Contractor for Jurisdiction E that includes California, Hawaii, Nevada, American Samoa, Guam, and Northern Mariana Islands. For non-private practices, the transition will occur on August 26, 2013 and for private practices, the transition will occur on September 16, 2013. To access the implementation page, click HERE.

Wisconsin Physician Services (WPS) has added a recording of a Part A teleconference to its Part B website. The web page contains an audio file and handouts. This would be applicable for providers in the states of Indiana, Iowa, Kansas, Michigan, Missouri, and Nebraska. To listen to the recording, visit the

A redetermination is an independent review of an initial claim determination performed by the same contractor that processed the original claim. This independent review is performed by staff not involved with making the original claim determination. A request for a redetermination must be submitted in writing and should be made on the standard Centers for Medicare & Medicaid (CMS)

National Government Services (NGS) has been awarded the Jurisdiction 6 A/B MAC contract for the administration of Medicare fee-for-service claims in 3 states as well as processing Medicare Home Health plus Hospice billings in 13 states and 5 U.S. territories. The 3 Medicare fee-for-service claims states are

Noridian Administrative Services (NAS) has been awarded the Jurisdiction E A/B MAC contract for the administration of the Part A and Part B Medicare fee-for-service claims in the states and territories of

For dates of service January 1, 2013 through December 31, 2013, all outpatient therapy claims submitted above the $3,700 threshold will be subject to prepayment medical review. CGS will send Additional Documentation Requests (ADRs) for all claims above the $3,700 threshold. In these ADRs, CGS will request the following documentation:

Palmetto GBA, Medicare contractor for California, Hawaii, and Nevada, will host a webinar on March 27, 2013 from 11:30AM-1:00PM PT. Skilled Nursing Facility services on both ends of the RUG-IV spectrum can be difficult to document and valuable information is often missing.  In this course designed for billers, nurses, MDS Coordinators, and physicians, we will explore documentation requirements for the Lower 14 RUGs as well as the highest RUGs, which fall into the Rehab Ultra High classification. To register, click HERE.