Provider Guides

Physicians and other healthcare professionals can demystify the Medicare process with these easy-to-follow provider guides covering topics including evaluation and management services, appeals, eligibility and coverage for beneficiaries, and more.

 
 Date PostedPublication
2/20/2018 Comparison of the Parts A, B, C, and D Appeal Processes 
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2/16/2018 PECOS FAQs 
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1/25/2018 Swing Bed Services 
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12/6/2017 Helping People with Medicare Part C & Part D Understand Their "Explanation of Benefits" (EOB) 
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9/12/2017 Medicare and Medicaid Provider Enrollment 
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9/12/2017 Maintaining Compliance with Enrollment Requirements and the Appeals Process 
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4/5/2017 Calculation of CMP Adjustments (2017) 
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1/19/2017 Hospice Payment System 
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10/27/2016 Provider Compliance Tips for Ordering Oxygen Supplies and Equipment 
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10/27/2016 Provider Compliance Tips for Skilled Nursing Facility Inpatient Services 
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10/20/2016 Provider Compliance Tips for Diabetic Test Strips 
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10/14/2016 Executive Summary of Final Rule Revising the Physician Fee Schedule 
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10/14/2016 The Quality Payment Program Overview Fact Sheet 
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4/28/2016 SNF VBP Proposals in the FY 2017 SNF PPS Proposed Rule  
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2/19/2016 Medicare Enrollment for Physicians and Other Part B Suppliers 
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2/18/2016 PECOS Technical Assistance Contact Information 
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1/28/2016 Medicare Advance Beneficiary Notices 
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12/10/2015 Health Care Professional Frequently Used Webpages 
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9/24/2015 Medicare Enrollment for Institutional Providers 
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8/22/2015 Nursing Home Enforcement FAQs 
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6/30/2015 Medicare Drug Coverage Under Medicare Part A, Part B, Part C, & Part D 
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6/17/2015 Therapy Caps Exceptions Process Extended Through CY 2017 
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5/28/2015 Memo to Long Term Care Facilities on Disenrollment Issues 
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12/15/2014 Repetitive Scheduled Non-Emergent Ambulance Transport Model Operational Guide 
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11/26/2014 Medicare Fee-For-Service Appeals Process Flowchart 
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9/11/2014 New Prior Authorization for Repetitive Scheduled Non-Emergent Ambulance Transport 
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9/11/2014 Ambulance Prior Authorization Provider Slides 
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1/27/2014 Medicare Post-Acute Care Episodes and Payment Bundling 
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10/14/2013 FAQs: 2 Midnight Inpatient Admission Guidance & Patient Status Reviews for Admissions on or After October 1, 2013 
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8/27/2013 FAQs: Functional Reporting - PT, OT, and SLP Services 
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8/23/2013 Medicare Part A and B: Surviving Signature Scrutiny 
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7/30/2013 Signature Attestation Statement (Example) 
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7/26/2013 Update on Medicare Demand Letters and Medicare Claims Cancellations due to an Item or Service Provided to Incarcerated Beneficiaries 
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6/27/2013 Medicare Payments: How Much Do Chronic Conditions Matter? 
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12/18/2012 Therapy Services - Medicare Part B 
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9/6/2012 Physical, Occupational, and Speech Therapy Services 
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6/26/2012 Notice of Denial of Payment 
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6/26/2012 Form Instructions for the Notice of Denial of Payment 
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6/25/2012 Notice of Exclusions From Medicare Benefits - Skilled Nursing Facility 
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6/14/2012 Notice of Denial of Medical Coverage 
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6/14/2012 Form Instructions for the Notice of Denial of Medical Coverage 
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6/13/2012 Detailed Explanation of Non-coverage 
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6/13/2012 Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) 
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5/9/2012 Calendar Year 2013 Medicare Advantage Capitation Rates and Medicare Advantage and Part D Payment Policies and Final Call Letter 
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3/20/2012 An Update on Medicare Part C and D 2012 Plan Ratings 
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3/20/2012 Medicare Parts C and D Fraud, Waste, and Abuse Training 
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3/12/2012 Policy and Requirements for an Application for Deeming Authority 
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