FAQs

Find answers to frequently asked Medicare questions below. You can view additional FAQs for Hospice providers on the CMS website. For help with eServices, view our eServices FAQs.


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How do I find Comprehensive Error Rate Testing (CERT) information in the eServices portal? 09/03/2019
Are providers required to submit medical records to the Medicare Administrative Contractor (MAC) for Recovery Audit Contractor (RAC) appeals? 07/23/2019
How are visits counted for continuous home care (CHC)? 07/23/2019
What is a PTAN? 07/23/2019
Are there any exceptions for unusual situations regarding the face-to-face requirement? 07/22/2019
As a hospice, are we required to fill out the Medicare Secondary Payer (MSP) questionnaire upon admission and then every 90 days? 07/22/2019
As the office manager/volunteer coordinator for a hospice, can I take a verbal order from a physician for a hospice referral? 07/22/2019
Can a home health agency (HHA) that provides therapy service and a nursing service on the same day only bill one G-code for that day? 07/22/2019
Can a Medicare patient receive home health and hospice at the same time? 07/22/2019
Can a provider remove an incorrect hospice revocation date from a discharge claim? 07/22/2019
Can a therapy assistant provide maintenance therapy visits? 07/22/2019
Can Medicare Secondary Payer and Tertiary Payer claims be submitted electronically? 07/22/2019
Can the face-to-face documentation be included with the plan of care (POC) and certification documentation? 07/22/2019
Does our hospice agency need to submit the notice of election along with the request for additional documentation requests/records? 07/22/2019
Does Palmetto GBA send the provider any communication that states the payment amount due includes the accrued interest for Recovery Audit Contractors (RAC) appeals that have gone to the Quality Improvement Organization (QIO) after the decision? 07/22/2019
Does the Certifying Physician in the Home Health agency record need to be reported on the claim? 07/22/2019
Hospice FAQs 07/22/2019
How are medical record requests handled for the Recovery Audit Contractors (RAC) related appeals/redeterminations? 07/22/2019
How do I find out why a claim has been returned to the provider (RTP) for correction? 07/22/2019
How do I know if Medicare is primary or secondary? 07/22/2019
How do we handle billing when an HMO patient, who is receiving home health services from us, disenrolls from the HMO and is eligible for Medicare? 07/22/2019
How long should a home health agency retain billing records, and where can I find that information? 07/22/2019
I cannot seem to locate your hospice or home health training manuals on the Palmetto GBA website. Are they obsolete? 07/22/2019
I have a lot of claims in 'S' status with reason code 30928. Can someone explain why my claims are being held? 07/22/2019
I have a patient who has an open liability claim on the Common Working File (CWF), but we are seeing him for services not related to the auto accident. How should I file these claims with Medicare? 07/22/2019
I submitted an electronic adjustment to correct a medically denied line, why was the claim returned to the provider (RTP)? 07/22/2019
If a hospice fails to recertify the patient should the agency discharge the patient or use span code 77? 07/22/2019
If a Recovery Audit Contractor (RAC) retracts due to a discussion or internal error, how is Palmetto GBA notified? What are the internal processes and timeframes? 07/22/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): January 2019 - March 2019 07/22/2019
Provider Enrollment Application: Frequently Asked Questions 07/22/2019
Should our home health agency discharge a patient that elects a Medicare Advantage (MA) Plan (also known as a Medicare HMO)? 07/22/2019
Some of my patients have open insurance records that they say are not valid anymore. Can you close them so my claims will process? 07/22/2019
What claim adjustment reason codes will be attached to a N432 or N469 Remittance Advice (RA) remark code on the remit? 07/22/2019
What is the Recovery Audit Contractor (RAC) appeal/redetermination process? 07/22/2019
What value code is utilized by home health agencies to report the CBSA? 07/22/2019
When do home health claims qualify for the LUPA add-on payment? 07/22/2019
When should home health agencies use the new condition code D2 on their claims? 07/22/2019
Where can I find information regarding home health patients transitioning from and/or to HMOs? 07/22/2019
Which benefit, Medicare or Medicaid, is responsible for paying for the months of care provided to the beneficiary before the signed election statement was obtained? 07/22/2019
Who qualifies as a non-physician practitioner (NPP)? 07/22/2019
Who should a provider contact about status of refund due to a Recovery Audit Contractor (RAC) retraction letter? 07/22/2019
Provider Contact Center (PCC) Frequently Asked Questions (FAQs): April 2019 - June 2019 07/17/2019
How do I make the text larger to make it easier to read? 06/19/2019
After I receive a 277CA will I receive anything else? 06/18/2019
Can I share my DDE ID? 06/18/2019
How can I tell if I am set up for Electronic Billing? 06/18/2019
How do I reset my DDE password? 06/18/2019
How do I restore a remit file? 06/18/2019
If I have an existing DDE ID with another company, can I request a new ID? 06/18/2019
Is the 277CA returned for each test submission? 06/18/2019
Is the Submitter ID required on the DDE enrollment form? 06/18/2019
PC-ACE Pro32 software FAQs 06/18/2019
What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance? 06/18/2019
What is a Network Service Vendor? 06/18/2019
What is an approved software vendor? 06/18/2019
What is the difference between a Submitter ID and a DDE ID? 06/18/2019
What provider address should I include on the EDI enrollment forms? 06/18/2019
What provider name should I include on the EDI enrollment forms? 06/18/2019
What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group? 06/18/2019
What Submitter Name should I enter on the Provider Authorization form? 06/18/2019
When is a provider authorization form required? 06/18/2019
Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description? 06/18/2019
Will you reject claims with a P.O. Box in the billing provider address? Will you reject claims where the group number and policy number are the same values? 06/18/2019
Do you have a coding question? 06/03/2019
What are the ordering and referring edits? 06/03/2019
What shall I do if I don't have an enrollment record in Medicare? 06/03/2019
Where can I find information about the New Medicare Cards project? Open in New Window06/03/2019
Who are the medical directors for Palmetto GBA? 06/03/2019
   

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