Displaying Ambulance Articles 1 to 25 of 106

Topic	Date	Description
Private Contracting/Opting out of Medicare	Tuesday, July 01, 2008	This article is based on CR6081 and notifies providers of the update by the Centers for Medicare & Medicaid Services (CMS) to Medicare Benefit Policy Manual, Chapter 15, sections 40.5, 40.6, 40.9, 40.11, 40.13, 40.20, 40.26, and 40.35.
Pinnacle Business Solutions, Inc. Holiday	Monday, June 30, 2008	Pinnacle Business Solutions, Inc. will be closed on Friday, July 4, 2008 in observance of the Independence Day Holiday. EDI Technical Support and Customer Service Representatives will not be available. The call center will open at our normal operating hours on Monday, July 7. We will be happy to serve you then.
Notification of New Quarterly Updates to the Ambulance Fee Schedule Public Use File (PUF)	Tuesday, June 17, 2008	This article is based on Change Request (CR) 6091, which informs Medicare providers that the Centers for Medicare & Medicaid Services (CMS) wants providers to know that since Medicare Claims Processing Contracting reform is on-going, some of the Contractor/Carrier numbers included in the 2008 annual Ambulance Fee Schedule Public Use File (PUF) posted to the CMS website may be outdated. To ensure that the Contractor/Carrier numbers contained in the file are as accurate as possible, a quarterly update to the PUF file, containing new Contractor/Carrier numbers, will be posted to the CMS website until all contracting reform is completed. The updated information will be highlighted with italicized red text and may be reviewed on the CMS web site at: http://www.cms.hhs.gov/AmbulanceFeeSchedule/02_afspuf.asp#TopOfPage.
Call Center Closing Times (Part B)	Monday, June 16, 2008	To better serve the provider community, the Centers for Medicare and Medicaid Services (CMS) is allowing Provider Contact Centers across the nation to conduct customer service training during normal business hours. The Medicare Program is very complex with continuous changes and this initiative will help prepare Provider Customer Service Representatives (CSR's) to give quality answers to substantive Medicare related questions or inquiries. Pinnacle Business Solutions, Inc. the Medicare Part B Carrier for Arkansas, Louisiana and Rhode Island will be participating in this program. We have developed a comprehensive training plan that includes closing our Provider Contact Center for up to eight hours each month. Using Provider Contact Center call distribution data to determine the least possible impact for our customers, we have selected the following closure dates and times for June 2008 and July 2008.
Call Center Closing Times (Part A)	Monday, June 16, 2008	To better serve the provider community, the Centers for Medicare and Medicaid Services (CMS) is allowing Provider Contact Centers across the nation to conduct customer service training during normal business hours. The Medicare Program is very complex with continuous changes and this initiative will help prepare Provider Customer Service Representatives (CSR's) to give quality answers to substantive Medicare related questions or inquiries. Pinnacle Business Solutions, Inc. the Medicare Part A Intermediary for the State of Rhode Island, will be participating in this program. We have developed a comprehensive training plan that includes closing our Provider Contact Center for up to eight hours each month. Using Provider Contact Center call distribution data to determine the least possible impact for our customers, we have selected the following dates in June 2008 and July 2008.
Instructions for Institutional Providers and Suppliers Billing Self-Referred Mammography Claims Regarding the Attending/Referring Physician National Provider Identifier (NPI)	Tuesday, June 10, 2008	This article is based on Change Request (CR) 6023 which provides National Provider Identifier (NPI) instructions for institutional providers and suppliers billing for self-referred mammography services. Do not use the surrogate unique physician identification number (UPIN) of "SLF000" on claims effective May 23, 2008. Providers of mammography services are instructed to report their own facility NPI in the attending physician NPI field in cases where the service is self-referred by the patient (beneficiary) and no attending/referring physician NPI is available. See the Background and Additional Information Sections of this article for further details regarding these changes.
July 2008 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files	Tuesday, June 10, 2008	CR 6049, from which this article is taken, instructs Medicare contractors to download and implement the July 2008 Average Sales Price (ASP) drug pricing file for Medicare Part B drugs; and if released by CMS, also the revised April 2008, January 2008, January 2007, April 2007, July 2007, and October 2007 files.
July Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)	Tuesday, June 10, 2008	Note: This article was revised on June 9, 2008, to correct the summary of CR6087 in the "Impact to You" section below. All other information remains the same. Payment files for the MPFS were issued based on the 2008 Medicare Physician Fee Schedule Final Rule. Change Request (CR) 6087 amends those files AND includes new/revised codes for the Physician Quality Reporting Initiative (PQRI). Physicians and providers may want to pay particular attention to the issue that effective July 1, 2008 payments are calculated using the conversion factor of $34.0682, update factor of 0.899 and without the work geographic adjustment, which is the previous payment methodology that was outlined in the 2008 MPFS Final Rule but was delayed as a result of the Medicare, Medicaid, and State Children’s Health Insurance Program (SCHIP) Extension Act of 2007. Make certain that your billing staffs are aware of these changes.
Pinnacle Business Solutions, Inc. Holiday	Monday, May 19, 2008	Pinnacle Business Solutions, Inc. will be closed on Monday, May 26, 2008 in observance of the Memorial Day holiday. EDI Technical Support and Customer Service Representatives will not be available. The EDI Gateway will be available for transmissions and report retrieval. No Medicare checks or Electronic Remits will be generated on these dates.
Assignment of Providers to Medicare Administrative Contractors	Friday, May 16, 2008	This "One Time Notice" CR describes the Centers for Medicare & Medicaid Services (CMS) approach for assigning providers to MACs and discusses the process of moving providers to MACs.
Ambulance Fee Schedule - Conversion Factor File for CY 2009 Ambulance Inflation Factor	Tuesday, May 13, 2008	Note: This article was revised on May 6, 2008, to correct the implementation date of the instruction. That date is October 6, 2008. All other information remains the same. This article is based on Change Request (CR) 6000 which revises the ambulance fee schedule file layout for Calendar Year (CY) 2009. Specifically, only the conversion factor field is being modified to: Remove the sign in the numeric field; and Expand the length of the Conversion Factor field. For claims with dates of service on or after January 1, 2009, Medicare contractor(s) will recognize the new Ambulance Fee Schedule file layout. For claims with dates of service prior to January 1, 2009, Medicare contractors will recognize the current layout.
Provider Authentication by Medicare Provider Contact Centers	Monday, May 05, 2008	SE0814 covers the implementation of the National Provider Identifier (NPI) and the Provider Transaction Access Number (PTAN), effective May 23, 2008, as the provider authentication elements used when providers make telephone or written inquiries to the Medicare fee-for-service contractor provider contact centers. Note: For providers enrolled in Medicare before May 23, 2008, their PTAN initially will be their legacy provider number. New providers enrolling in Medicare on or after May 23, 2008, will be assigned a PTAN as part of the Medicare enrollment process.
New HCPCS Codes for the April 2008 Update	Tuesday, April 22, 2008	This article is based on Change Request (CR) 5981, which instructs Medicare Contractors to implement Healthcare Common Procedure Coding System (HCPCS) code changes effective April 1, 2008. Make sure that your billing staffs are aware of these changes.
Announcing the Release of the Revised CMS-855 Medicare Enrollment Applications	Thursday, April 03, 2008	The Centers for Medicare & Medicaid Services (CMS) issued revised CMS-855 Medicare enrollment applications in March 2008. With the exception of providers enrolling as a specialty hospital on the CMS-855A, Medicare contractors will continue to accept the 2006 version of the Medicare enrollment application through June 2008. Providers and suppliers should begin to use the new Medicare enrollment applications immediately. Initially, these applications will be available only from the CMS provider enrollment web site. The link for that CMS web site is listed in the Additional Information section of this article. Over the last year, CMS has received numerous comments and suggestions regarding the proposed revisions to the Medicare enrollment applications. CMS reviewed the comments and adopted many of the suggested revisions. Also, CMS incorporated a number of enhancements and changes (see Key Points below) to clarify the enrollment process and to reduce the burden imposed on the provider and supplier communities. This Special Edition outlines the significant revisions to the Medicare enrollment applications.
April Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)	Tuesday, March 25, 2008	This article is based on Change Request (CR) 5980 which amends payment files previously issued to Medicare contractors based upon the 2008 Medicare Physician Fee Schedule Final Rule. CR 5980 also includes new/revised codes for the Physician Quality Reporting Initiative (PQRI).
Remittance Advice Remark Code (RARC) and Claim Adjustment Reason Code (CARC) Update	Wednesday, March 12, 2008	CR 5942, from which this article is taken, announces the latest update of Remittance Advice Remark Codes (RARCs) and Claim Adjustment Reason Codes (CARCs), effective April 1, 2008. Be sure billing staff are aware of these changes.
Collapsing Medicare Provider Transaction Access Numbers (PTANs) to Ensure a One-to-One National Provider Identifier (NPI) Match	Wednesday, March 05, 2008	The Centers for Medicare & Medicaid Services (CMS) issued Change Request (CR) 5906 because it believes that providers and suppliers may want to collapse their assigned Medicare PTANs to insure a one-to-one NPI match. Providers may collapse PTANs that are assigned to additional locations only if the additional locations are all assigned the same tax identification number (TIN) and are within the same pricing locality.
2008 Rhode Island Ambulance Fee Schedule – Revised	Wednesday, February 27, 2008	The Revised 2008 Rhode Island Ambulance Fee Schedule has been posted online.
Ambulance Fee Schedule Fact Sheet	Monday, February 25, 2008	The Ambulance Fee Schedule Fact Sheet, which provides general information about the Ambulance Fee Schedule, is now available in downloadable format from the Centers for Medicare & Medicaid Services Medicare Learning Network at: http://www.cms.hhs.gov/MLNProducts/downloads/AmbulanceFeeSched_508.pdf
Upcoming Critical Dates for Medicare’s Fee-for-Service (FFS) Implementation of the National Provider Identifier (NPI)	Monday, February 11, 2008	This special edition article, SE0802, is being provided by the Centers for Medicare & Medicaid Services (CMS) in order to clear up some confusion that providers are experiencing regarding the March 1, 2008 implementation of the NPI on professional claims, and the May 23, 2008 requirement for ONLY the NPI on all Health Insurance Portability & Accountability Act (HIPAA) electronic transactions and their paper versions.
Emergency Update to the 2008 Medicare Physician Fee Schedule Database (MPFSDB)	Friday, February 08, 2008	The article is based on Change Request (CR) 5902 which amends payment files that were issued to Medicare contractors based upon the November 1, 2007, Medicare Physician Fee Schedule (MPFS) Final Rule.
Medicare Fee for Service Legacy Provider IDs Prohibited on Form CMS-1500 Claims after NPI Required Date	Wednesday, February 06, 2008	Effective May 23, 2008, if you report a Provider Legacy Identifier on Medicare CMS-1500 or CMS-1450 (UB-04) claims, your contractors will return them as unprocessable. CR 5858, from which this article is taken, announces that Provider Legacy Identifiers are not to be reported on Medicare CMS-1500 or Form CMS-1450 claims received on or after May 23, 2008 (the date at which the NPI is required to be reported on claims). After that date, claims containing Legacy Identifiers will be returned as unprocessable. Make sure that your billing staffs are aware that effective May 23, 2008, only NPIs are to be reported on Medicare CMS-1500 and CMS-1450 claims.
EMERGENCY -- Legislative Change Affecting the 2008 Medicare Physician Fee Schedule (MPFS), and Extension of the 2008 Participation Open Enrollment Period	Tuesday, February 05, 2008	CR5944, from which this article is taken, provides Medicare contractors with information about (and instructions for implementing) legislative changes to the 2008 MPFS, and about the extension of the Participation Open Enrollment period for 2008. Effective for claims with dates of service January 1, 2008, through June 30, 2008, the update to the conversion factor will be 0.5%; and for claims with dates of service July 1, 2008 and after, will revert back to the previous payment methodology (the -10.1% update) that was outlined in the Final Rule, published in the Federal Register on November 27, 2007. Additionally, the Centers for Medicare & Medicaid Services (CMS) has extended the 2008 Participation Open Enrollment period from December 31, 2007, to February 15, 2008 – therefore, it now runs from November 15, 2007 through February 15, 2008.
Ambulatory Surgical Center (ASC) Claims Processing Manual Clarification	Monday, February 04, 2008	Note: This article was revised on January 24, 2008, to add a reference to SE0742. SE0742 announced that CMS was implementing significant revisions to the payment system for ASC services beginning with services rendered on or after January 1, 2008. SE0742 may be found at http://www.cms.hhs.gov/MLNMattersArticles/downloads/se0742.pdf on the CMS website. All other information remains the same. This article is for informational purposes. CR5026 revises the Medicare Claims Processing Manual, Chapter 14 (Ambulatory Surgical Centers), Sections 10.3 (Services Furnished in ASCs Which Are Not ASC Facility Services) and 10.4 (Coverage of Services in ASCs Which Are Not ASC Facility Services) to clarify policy regarding the provision, coverage, and payment of services furnished in an ASC.
Tips for Searching the Pinnacle Medicare Services Web Site	Thursday, January 31, 2008	The Pinnacle Medicare Services Web site search function offers several ways to search for information. The following is an overview of the search function to assist providers with searching our web site.
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