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Related Web Sites This Web page provide links to related health care sites that expand upon the information we provide. Please note, that these links take you away from the NHIC, Corp. (NHIC) Medicare site. NHIC cannot and does not make any representation about these sites or the materials available on them.
The Centers for Medicare & Medicaid Services (CMS) •CMS' Competitive
Acquisition Program This page on the CMS website contains information on the competitive acquisition program (CAP) for Medicare Part B drugs and biologicals not paid on a cost or prospective payment system basis. Physicians are given a choice between buying and billing these drugs under the average sales price (ASP) system, or obtaining these drugs from vendors selected in a competitive bidding process. This page on the CMS website contains program related forms in Portable Document Format (pdf). These include claim forms, enrollment applications, ABN forms, and many more. This page on the CMS website contains vast amounts of information related to HIPAA, including: General Information, Regulations & Standards, Enforcement Issues, Educational Materials, Upcoming Events, and Related Links. •
CMS Influenza Pandemic Emergency Preparedness The Centers for Medicare and Medicaid Services has developed certain emergency policies and procedures that may be implemented in the event of an influenza pandemic. Providers must await guidance from NHIC, Corp. and CMS before considering any pandemic policy to be operationally effective. You should also monitor the CMS Web site at http://www.cms.hhs.gov/Emergency/10_PandemicFlu.asp. The CMS Online Manual System is used by CMS program components, partners, contractors, and State Survey Agencies to administer CMS programs. It offers day-to-day operating instructions, policies, and procedures based on statutes and regulations, guidelines, models, and directives. • CMS Medicare Learning Network This section includes a variety of mechanisms, such as the Internet, national educational articles, brochures, fact sheets, web-based training courses, and videos, to deliver a planned and coordinated provider education program. • CMS' MREP Software information Download CMS Medicare Remit Easy Print (MREP) software and user guide. This software will enable providers to read and print the Health Insurance Portability and Accountability Act (HIPAA) compliant electronic remittance advice (ERA). The provider/supplier-specific pages are a one-stop resource focused on the informational needs and interests of Medicare Fee-for-Service (FFS) providers, including physicians, other practitioners. • CMS Quarterly Provider Update (QPU) Source for National Medicare Provider Information. This is a listing of quarterly regulations and instructions for Medicare providers. You can receive changes to this Update, as CMS makes them, by subscribing to the CMS-QPU Listserv. The provider/supplier-specific pages are a one-stop resource focused on the informational needs and interests of suppliers. Program transmittals are used to communicate new or changed policies, and/or procedures that are being incorporated into a specific Centers for Medicare & Medicaid Services (CMS) program manual. • Competitive Acquisition for DMEPOS • Consolidated Billing for Skilled Nursing Facility (SNF) Information Under the Consolidated Billing requirement, a SNF itself must submit all Medicare claims for the services that its residents receive (except for specifically excluded services listed below). • Correct Coding Initiative Edits (CCI) Information for providers on Medicare's National CCI edits. • E&M Services - Documentation Guidelines CMS Documentation Guidelines for Evaluation & Management Services CMS establishes uniform national definitions of services, codes to represent services, and payment modifiers to the codes. • Laboratory National Coverage Determinations (NCDs) Index Listed are the Laboratory NCDs, including accompanying issuances, resulting from Negotiated Rulemaking. • Medicare Contractor Provider Satisfaction Survey (MCPSS) The Medicare Contractor Provider Satisfaction Survey (MCPSS) is designed to garner quantifiable data on provider satisfaction with the performance of Medicare Fee-for-Service (FFS) Contractors. • Medicare Coordination of Benefits (COB) This section of the CMS Web site centralizes all coordination of benefits information. The purposes of the COB program are to identify the health benefits available to a Medicare beneficiary and to coordinate the payment process to prevent mistaken payment of Medicare benefits. This section includes information for beneficiaries, providers, employers and attorneys. • Medicare Prescription Drug Coverage for Providers This page consists of educational products, standard forms, training courses, products to use in counseling patients, CMS communications and links to additional resources for the Medicare Part D Drug Coverage. • National Coverage Determinations (NCDs) An NCD sets forth the extent to which Medicare will cover specific services, procedures, or technologies on a national basis. This page lists all current NCDs. •
National Physician Fee Schedule
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Unadjusted CMS website that contains the unadjusted for budget neutrality factor for private insurance contracting. Choose the year. Open/download the winzip file which contains numerous documents. For the Addendum B fee schedule for 2008, refer to the document/spreadsheet titled “PPRVU08.xls”. •
National Provider Identifier (NPI) The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers. Covered health care providers and all health plans and health care clearinghouses will use the NPIs in the administrative and financial transactions adopted under HIPAA. •
Physician Quality Reporting Initiative (PQRI) PQRI establishes a financial incentive for eligible professionals to participate in a voluntary quality reporting program. Eligible professionals who successfully report a designated set of quality measures on claims for dates of service from July 1 to December 31, 2007, may earn a bonus payment. Associations & Organizations • American Academy of
Allergy, Asthma, and Immunology • American Academy of Ophthalmology • American Ambulance Association • American Association
of Orthopaedic Surgeons • American Chiropractic
Association •
American
Hospital
Association Central Office: Clearinghouse for ICD-9-CM & HCPCS
codes The American Hospital Association's Central Office serves as the official U.S. clearinghouse on medical coding for the proper use of the ICD-9-CM systems and Level I HCPCS (CPT-4 codes) for hospital providers and certain Level II HCPCS codes for hospitals, physicians and other health professionals. Online resources for individuals interested in information on asthma and other lung diseases. • American Medical Association Online resources for physicians. Links to state and local medical societies. • American
Optometric Association • American Podiatric Medical
Association • American Society of Clinical
Oncology •
Association for
Psychological Science • Maine
Chiropractic Association • Massachusetts
Chiropractic Society • Massachusetts
Medical Society • Massachusetts
Podiatric Medical Society •
Massachusetts Society of
Optometrists •
Medicare Contractor Advisory Committee (CAC) This site is restricted to CAC members only. • National
Association of Social Workers Membership services include group rate malpractice insurance, online jobs bulletin, discount continuing education, and advocacy services. This site includes a wide range of cancer information, available for health professionals. • National
Institutes of Health • National
Library of Medicine Search the Medline database. Many other resources for physicians and health professionals. • New
England Journal of Medicine • The New Hampshire
State Medical Society • New Hampshire
State Chiropractic Society • Radiological
Society of North America The information in
this section is maintained by the
Washington Publishing Company (WPC) •
Clearinghouse
for ICD-9-CM & HCPCS codes The American Hospital Association's Central Office serves as the official U.S. clearinghouse on medical coding for the proper use of the ICD-9-CM systems and Level I HCPCS (CPT-4 codes) for hospital providers and certain Level II HCPCS codes for hospitals, physicians and other health professionals. •
Code of Federal Regulations (CFR)
•
Diversified Collection Services This is the new one-stop-shop type of page that the government has created to make it easy for citizens to participate in Federal rulemaking and the American democratic process. From this Web site, you can view a description of every proposed and final Federal regulation currently open for comment, read the full text of the regulations, and submit your comments to the Federal agencies responsible for the rulemaking action. •
Medicare The official US government site for people with Medicare. •
Medicare Contractor Provider Satisfaction Survey (MCPSS) The MCPSS is a continuous survey of a nationally representative sample of physicians and provider population, conducted by the Centers for Medicare Management (CMM) for Centers for Medicare & Medicaid Services (CMS) through a contract with Westat. This site provides information about MCPSS to the physician and provider community, provider organizations and associations and particularly to our Medicare FFS Contractors. •
The
Medicare Rights Center (MRC) •
NPI Registry-National Plan & Provider Enumeration System (NPPES) The comprehensive source for Medicare National Provider Identifiers (NPI). •
Social
Security Act - Title XV111 •
Social Security Administration Interest must be paid on clean claims if payment is not made within the applicable number of calendar days (i.e., 30 days) after the date of receipt. Interest is paid at the rate used for §3902(a) of title 3l, U.S. Code (relating to interest penalties for failure to make prompt payments). The interest rate is determined by the applicable rate on the day of payment. This rate is determined by the Treasury Department on a 6-month basis, effective every January 1 and July 1. Providers may access the Treasury Department Web page. •
TRICARE The Military Health System
04/29/2010 |
