Checklist: Transitional Care Management services documentation
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
This checklist is intended to provide health care providers with a reference for use when responding to medical documentation...
Review the top denial/partial denial reasons and high-level results from each round of DRG 226 and 267 TPE.
Read this article for tips on how to prevent claim adjustment reason code (CARC) PR 96.
A lump-sum adjustment is made depending on whether there is an underpayment or overpayment determined as a result of the interim review. These adjustments are summarized by the First Coast financial department. To accurately and timely report these lump-sum adjustments when preparing your cost report, please submit your request for detailed payment information to payinfo@novitas-solutions.com.
Cost reporting requirements have been eliminated for CORFs and OPTs where 100 percent of the services are reimbursed on a fee schedule basis. Community mental health centers (CMHCs) must continue to file cost reports in accordance with the CMS website, Medicare Provider Reimbursement Manual Part 2 (PRM 15-2), Provider Cost Reporting Forms and Instructions, Chapter 1, Section 133.
If you did not furnish any covered services to Medicare beneficiaries during the entire cost reporting period, a full cost report is not required. We may authorize less than a full cost report where a provider has had low utilization of covered services by Medicare beneficiaries in a reporting period and received correspondingly low interim reimbursement payments.
If you would like to expedite a request for an extended repayment schedule, please send an email to FCSO-ERS@FCSO.com. You can find the appropriate form and certification on our website by clicking here. In addition, include a copy of the first payment of the check. Mail the check to:
Checks are to be made payable to First Coast Service Options Inc. They should be annotated with your provider name, number, and cost report year end that applies to the amount due. The original check should not be attached to the cost report but should be mailed to:
First Coast Service Options Inc.
Medicare Part A Debt Recovery
P.O. Box 3162
Mechanicsburg, PA 17055-1837
First Coast encourages all providers to submit cost reports and supporting documentation electronically whenever possible. In addition to the environmental benefits of this approach, it is also more efficient from a time and cost perspective.
The PC-ACE Professional Training Module provides instructions necessary to set up and use the PC-ACE software.