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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Who are the medical directors for Palmetto GBA? 11/20/2018
Does the Certifying Physician in the Home Health agency record need to be reported on the claim? 10/10/2018
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? 10/10/2018
Provider Enrollment Application: Frequently Asked Questions 10/09/2018
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? 10/08/2018
Hospice Change Request (CR) 8358 Questions and Answers 10/08/2018
Hospice FAQs 10/08/2018
How are medical record requests handled for the Recovery Audit Contractors (RAC) related appeals/redeterminations? 10/08/2018
How are visits counted for continuous home care (CHC)? 10/08/2018
How do I find out why a claim has been returned to the provider (RTP) for correction? 10/08/2018
How do I know if Medicare is primary or secondary? 10/08/2018
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? 10/08/2018
How long should a home health agency retain billing records, and where can I find that information? 10/08/2018
I cannot seem to locate your hospice or home health training manuals on the Palmetto GBA website. Are they obsolete? 10/08/2018
I have a lot of claims in 'S' status with reason code 30928. Can someone explain why my claims are being held? 10/08/2018
I submitted an electronic adjustment to correct a medically denied line, why was the claim returned to the provider (RTP)? 10/08/2018
If a hospice fails to recertify the patient should the agency discharge the patient or use span code 77? 10/08/2018
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? 10/08/2018
Should our home health agency discharge a patient that elects a Medicare Advantage (MA) Plan (also known as a Medicare HMO)? 10/08/2018
Some of my patients have open insurance records that they say are not valid anymore. Can you close them so my claims will process? 10/08/2018
The recertification statement must indicate the continuing need for services and estimate how much longer the services will be required. Does this statement need to identify the specific discipline providing the skilled service? 10/08/2018
What claim adjustment reason codes will be attached to a N432 or N469 Remittance Advice (RA) remark code on the remit? 10/08/2018
What is a PTAN? 10/08/2018
What is the Recovery Audit Contractor (RAC) appeal/redetermination process? 10/08/2018
What value code is utilized by home health agencies to report the CBSA? 10/08/2018
When do home health claims qualify for the LUPA add-on payment? 10/08/2018
When should home health agencies use the new condition code D2 on their claims? 10/08/2018
Where can I find information regarding home health patients transitioning from and/or to HMOs? 10/08/2018
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? 10/08/2018
Who should a provider contact about status of refund due to a Recovery Audit Contractor (RAC) retraction letter? 10/08/2018
Are providers required to submit medical records to the Medicare Administrative Contractor (MAC) for Recovery Audit Contractor (RAC) appeals? 10/05/2018
Are there any exceptions for unusual situations regarding the face-to-face requirement? 10/05/2018
As a hospice, are we required to fill out the Medicare Secondary Payer (MSP) questionnaire upon admission and then every 90 days? 10/05/2018
As the office manager/volunteer coordinator for a hospice, can I take a verbal order from a physician for a hospice referral? 10/05/2018
Can a Medicare patient receive home health and hospice at the same time? 10/05/2018
Can a therapy assistant provide maintenance therapy visits? 10/05/2018
Can Medicare Secondary Payer and Tertiary Payer claims be submitted electronically? 10/05/2018
Can the face-to-face documentation be included with the plan of care (POC) and certification documentation? 10/05/2018
Does our hospice agency need to submit the notice of election along with the request for additional documentation requests/records? 10/05/2018
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? 10/05/2018
Who qualifies as a non-physician practitioner (NPP)? 10/05/2018
Can a provider remove an incorrect hospice revocation date from a discharge claim? 10/01/2018
What information do I need to have available when calling for Electronic Data Interchange (EDI) assistance? 09/15/2018
After I receive a 277CA will I receive anything else? 09/14/2018
Can I share my DDE ID? 09/14/2018
How can I tell if I am set up for Electronic Billing? 09/14/2018
How do I reset my DDE password? 09/14/2018
How do I restore a remit file? 09/14/2018
If I have an existing DDE ID with another company, can I request a new ID? 09/14/2018
Is the 277CA returned for each test submission? 09/14/2018
Is the Submitter ID required on the DDE enrollment form? 09/14/2018
PC-ACE Pro32 software FAQs 09/14/2018
What is a Network Service Vendor? 09/14/2018
What is an approved software vendor? 09/14/2018
What is the difference between a Submitter ID and a DDE ID? 09/14/2018
What provider address should I include on the EDI enrollment forms? 09/14/2018
What provider name should I include on the EDI enrollment forms? 09/14/2018
What PTAN should I enter on the EDI enrollment forms if the provider is a member of a group? 09/14/2018
What Submitter Name should I enter on the Provider Authorization form? 09/14/2018
When is a provider authorization form required? 09/14/2018
Where in the 277 CA file can we find the rejection message that provides the detailed rejection reason description? 09/14/2018
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? 09/14/2018
Do you have a coding question? 09/05/2018
How do I find Comprehensive Error Rate Testing (CERT) information in the eServices portal? 09/05/2018
What are the ordering and referring edits? 09/05/2018
What shall I do if I don't have an enrollment record in Medicare? 09/05/2018
Where can I find information about the New Medicare Cards project? Open in New Window09/05/2018
   

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