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Customer Service Frequently Asked Questions
North Carolina - First Quarter 2006
- Where can I find the 2006 fee schedule information and approved codes for Ambulatory Surgical Centers?
- I have been receiving “rebate” checks from your organization and do not know what this check is for. Can you please clarify?
- I have not received the 2006 ICD-9 CM code book. Where I can find a listing of updated diagnosis codes so that I can submit my claims?
- Since CMS has redesigned their website, I’m having a little trouble finding information, do you have any suggestions?
- I just used the IVR system to obtain claim status information. Can you verify whether or not I received the correct information regarding my claim?
- Where can I find the 2006 fee schedule information and approved codes for Ambulatory Surgical Centers?
A.
Information regarding the FY 2006 payment for ASC was published in the November 2005 Medicare Bulletin. The current ASC payment rates and wage index values remain in effect for FY 2006. A listing of the ASC codes (approved, added, and deleted) can be found on the CMS website at: http://www.cms.hhs.gov/ASCPayment/.
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- I have been receiving “rebate” checks from your organization and do not know what this check is for. Can you please clarify?
A.
If you have received a “rebate” check, this is a HPSA Bonus payment. A cover letter included with your check should state “This check is for a HPSA payment”, followed by Reason Code “B2” (rebate).
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- I have not received the 2006 ICD-9 CM code book. Where I can find a listing of updated diagnosis codes so that I can submit my claims?
A. If you have not yet received the 2006 ICD-9 CM code book, the CMS website has a section that provides information related to ICD-9 coding, which includes a list of the new /revised and deleted codes. You can access this information at http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/01_Overview.asp.
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- Since CMS has redesigned their website, I’m having a little trouble finding information, do you have any suggestions?
A. Although CMS has redesigned their website, we have identified several links that may be helpful to you. Please refer to the following links:
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- I just used the IVR system to obtain claim status information. Can you verify whether or not I received the correct information regarding my claim?
A. The IVR system is designed to pull claim and patient information directly from the same system used by Customer Service. Once you have obtained claim status information from the IVR, it is not necessary to call Customer Service unless there is a problem with the claim in question. The CMS requires providers to use the IVR system to check the status of claims. Deductible status, allowable amounts, denial reasons, check amounts, and other processing information can also be obtained through the IVR system. Our Customer Service staff is available to assist you with issues/problems that can not be resolved via the IVR.
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