June 30, 2013 is the last day to submit a hardship exemption for the e-prescribing penalty to the Centers for Medicare & Medicaid Services (CMS), or report 10 instances of e-prescribing on claims to CMS to avoid next year’s 2% payment reduction. Providers who are penalized will see this reduction on each Medicare Part B claim as it is processed January 1 through December 31, 2014.
The Centers for Medicare & Medicaid Services (CMS) recently announced they will move forward with Phase 2 of the ordering/referring edits effective May 1. These requirements apply to ordered/referred items and services including Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS), clinical laboratory and imaging services, and home health claims billed by Medicare Part B suppliers.
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Section 1869 of the Social Security Act and 42 C.F.R. Part 405 Subpart I contain the procedures for conducting appeals of claims for Medicare Part A and Part B. There are five levels in the claims appeals process for Medicare Part A and Part B which include.
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum on the Manual Medical Review of Therapy Claims today, September 5, 2012, from 2:00pm-3:30pm ET.
The purpose of this forum is to provide an opportunity for providers to ask questions about the mandated manual medical review of therapy services from October 1-December 31, 2012 for Medicare Part B services that was enacted by the Middle Class Tax Relief and Job Creation Act of 2012. CMS will also discuss therapy documentation requirements on the call.
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