Complete Story
06/05/2018
WPS Recent Oncology Related News
Part A, Part B and Part A/B News
WPS PART A-Outpatient Hospital Only
No Oncology Related News at this time.
WPS PART B-Private Practice Only
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
- Submit your request on your schedule, not ours (the WPS GHA Portal is available 24 hours a day, 7 days a week).
- No form to print and complete.
- No need to go to the post office, or even the fax machine!
- Receive immediate notification when your claim adjustment has been accepted.
- Receive immediate notification if your request is not a valid CER submission.
- After submission, use the portal to track your adjustment, determine when it is finalized, and find payment information.
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
Medicare Patient Signature Requirements
The CMS Internet-Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 1, Section 50, includes signature requirements for Medicare patients. These apply to both assigned and non-assigned claims and are applicable when submitting paper or electronic claims to Medicare. Providers and suppliers must retain these signature authorizations, in the event of an audit.
Payment for Medical Records for CERT Claim Reviews
Recent claim reviews performed by the Comprehensive Error Rate Testing (CERT) contractor have noted significant error findings because there was no response received from the provider after the fourth request for medical records. Upon further examination, some providers or their third-party storage contractors are requesting payment for medical records before they will submit them.
Neither WPS GHA nor the CERT contractor will reimburse for the cost of submitting medical record documentation for a Medicare claim review. It is the responsibility of the health care provider to furnish sufficient information to determine whether payment is due on a claim for federal funds reimbursement. Any cost the provider incurs by making this information available to Medicare is considered part of the health care provider's administrative costs.
You can find additional information on the CMS website in the Internet-Only Manual (IOM) Publication 100-08, Chapter 3, Section 3.2.3.6. Please share this information with your Medical Records Staff or independent records contractor.
MEDICARE HOT LINKS
Addendum B Update (HOPPS Fee Schedule for Services & Drugs)
Current ASP Drug Pricing Files
Quarterly Updated to CCI Edits
2018 FINAL RULES
Physician Fee Schedule Fact Sheet
2017 FINAL RULES
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