WPS PART A-Outpatient Hospital Only
2018 Quarterly CERT Review Findings
WPS PART B-Private Practice Only
2018 Quarterly CERT Review Findings
Are you interested in learning about the most recent Comprehensive Error Rate Testing (CERT) review findings for WPS GHA J8 providers? Find the latest CERT Quarterly Error Finding Report for J8 Part B MAC and get important educational resources to help you avoid these findings in your practice!
Fast, Easy, Secure - Use the WPS GHA Portal to Submit Reopening Requests
Do you need to make a minor change to a previously filed claim? Save time and money by using the WPS GHA Portal to submit your Clerical Error Reopen (CER) request.
Advantages of Using the Portal
More information about using the portal to submit a CER is available in "How to Submit Your Clerical Error Reopening (CER) via the WPS GHA Portal."
Not a current portal user? Register for an account and begin taking advantage of this, and other portal features, today.
WPS PART A & PART B
A55639 Chemotherapy Agents for Non-Oncological Conditions Updated and Reformatted
The article, "Chemotherapy Agents for Non-Oncological Conditions," addresses chemotherapy administration codes which apply to parenteral administration of anti-neoplastic agents provided for treatment of noncancer diagnoses or to substances such as monoclonal antibody agents, and other biologic response modifiers.
The article has been updated and reformatted to support Article Guidance on Non-Oncological Conditions. The revision will be viewable October 1, 2018, on the Medicare Coverage Database.
For more information, see the full news article on our website.
Avoid Delays in First and Second Level Appeals
Providers are submitting the second level appeal (reconsideration) request to WPS GHA when it should be going to the Qualified Independent Contractor (QIC). WPS GHA has seen an increase in the number of appeals being forwarded to the QIC which causes delays in processing your first level appeals (redetermination) as we need to determine which level you are requesting. The process also delays the reconsideration as we have 60 days to determine if the appeal is at the correct level. Help yourself today and submit to the correct contractor. For more information on the appeals process, see "How to Appeal the Claim Determination."
MEDICARE HOT LINKS
Addendum B Update (HOPPS Fee Schedule for Services & Drugs)
Current ASP Drug Pricing Files
Quarterly Updated to CCI Edits
2019 PROPOSED FINAL RULES
Physician Fee Schedule Fact Sheet
2018 FINAL RULES
Physician Fee Schedule Fact Sheet