 | FAQs |
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| Ambulance |
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| | I received a denial for my submission of a specialty care transport code. What could be wrong? | 02/16/2010 | |
| | Why am I getting denials for my ALS/SCT transports? | 01/25/2010 | |
| | Why is Palmetto GBA paying claims that should not be paid when I submit the GZ modifier? | 01/25/2010 | |
| Appeals |
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| | When Part B claims are reviewed and denied or downcoded by Medical Review, should another claim be billed to seek payment? | 02/16/2010 | |
| | Do I need to submit a copy of the related LCD policy when requesting a redetermination? | 01/25/2010 | |
| | How do we follow up on a claim already in the appeals process? | 01/25/2010 | |
| | What is the RAC adjustment Code? | 01/25/2010 | |
| | Will supporting documentation be required for all adjustments-paper and electronic claim adjustments? | 01/07/2010 | |
| Claims |
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| | Do we need to request permission to submit paper claims to Palmetto GBA? | 02/16/2010 | |
| | When a resident is in a covered Part A stay, receives services from an outside provider, and the provider sends a 1500 bill to the SNF for payment, we use the CMS Carrier File 1 to determine the SNF's responsibility. Is this correct? | 02/16/2010 | |
| | Will Medicare pay for the administration/infusion of a covered drug when the facility is billing the beneficiary as a cash patient and not billing Medicare? | 02/16/2010 | |
| | All of our electronic claims submitted with Modifer 62 for kidney and pancreatic transplants are denying. We are faxing the operative reports since the indicator is 1. | 01/25/2010 | |
| | Does Palmetto GBA only accept paper claims printed from a laser printer? | 01/25/2010 | |
| | I have faxed documentation to the appropriate fax number with the proper cover sheet, but my service is still denied for lack of documentation/fax. What do I need to do? | 01/25/2010 | |
| | What will happen to my claim if submitted with the patient’s incorrect date of birth? | 01/25/2010 | |
| | When billing for code 66984, claims are rejecting for missing documentation, order, notes, summary, report and/or chart. Documentation was included on the electronic claim and modifier 55 was used. What is needed? | 01/25/2010 | |
| | When debridement is done by primary care physician but in the hospital, on a hospitalized patient, two procedures should be paid if modifier 25 is used or should a different modifier be used? | 01/25/2010 | |
| Correct Coding Initiative (CCI) |
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| | What should I do if the 59 modifier was not reported correctly on the first claim submission? | 02/16/2010 | |
| | How should modifier 59 be reported under the CCI? | 01/26/2010 | |
| | If I want to determine what codes/procedures are paired with a certain code, how can I find out? | 01/26/2010 | |
| e-Mail Updates |
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| | How can I cancel receiving e-mail updates? | 01/26/2010 | |
| EDI |
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| | Can I check beneficiary eligibility online? If not, how can I check it? | 01/26/2010 | |
| | I am a clearinghouse, and I have several brand new providers I would like to set up under my submitter ID. What is the turnaround time for setting up EDI products and services for new providers? | 01/20/2010 | |
| | What does the error message 'R MSG NPI Not Submitted in Pay To Prov Loop' mean? | 01/20/2010 | |
| | What is the difference between a 'rejection' and a 'denial', and where do I go to resolve these when I receive one? | 01/20/2010 | |
| | Are EDI Enrollments (aka EDI Agreements) required by Jurisdiction 1? | 01/19/2010 | |
| | How can I verify that my transmission has reached Palmetto GBA? | 01/19/2010 | |
| | How do I link a Provider ID to a J1 Submitter ID? | 01/19/2010 | |
| Education |
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| | How do I register for listservs? | 02/16/2010 | |
| | Are education opportunities available? | 01/26/2010 | |
| | Acronym/Terminology Index | 12/21/2009 | |
| EFT |
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| | Does Palmetto GBA send hardcopy Remittance Advices (RAs) if we receive payment by EFT? | 02/16/2010 | |
| | Does Palmetto GBA supply appeal status through the customer service line? | 02/16/2010 | |
| | If only the NPI number was put on the EFT application, will it be sent back? | 02/16/2010 | |
| | Can I fax the CMS 588 Form to Palmetto GBA? | 01/27/2010 | |
| | How are we notified of an EFT payment? | 01/27/2010 | |