The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for June 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for June 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for May 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for May 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for April 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for April 2019 are now available. Please take time to review these errors and avoid them on future claims.
Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2019 (Change Request (CR) 11217), published on April 5, 2019, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates of service on or after January 1, 2019. Mass adjustments on previously paid 2019 claims will begin mid-May 2019. The new rates are listed below.
Lower 48 States
Medicare Inpatient Ancillary Part B - $789
Medicare Outpatient per Visit Rate - $405
Alaska
Medicare Inpatient Ancillary Part B - $1,144
Medicare Outpatient per Visit Rate - $646
The 2019 Medicare Satisfaction Indicator (MSI) survey, which allows you to share your comments on our services with CMS and Novitas Solutions, will remain available for just a limited time. If you have completed a survey this year, we appreciate it! If you have yet to visit the survey, or previously attempted to and needed more time to complete one, we would love to hear from you. Survey results will help us gain valuable insight about what works well for you and determine process improvements.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for March 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for March 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for February 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for February 2019 are now available. Please take time to review these errors and avoid them on future claims.
Change request (CR) 11163 adds procedure codes G2001-G2009 and G2013-G2015 to the MPFS effective for dates of service on and after January 1, 2019. The Centers for Medicare & Medicaid Services (CMS) communicated instructions for new codes G2001-G2009 and G2013-G2015 through a separate CR (CR 10907). Please consult MLN Matters article MM10907 external PDF file for these instructions and other information. In addition, CR 11163 revises the assistant surgery, co-surgeon, and team surgeon indicator for code G9987.
Contractors will not search their files to either retract payment for claims already paid or to retroactively pay claims, however, they will adjust claims that you bring to their attention.
In accordance with the Medicare Claims Processing Manual (Publication 100-04), Chapter 23, Section 30.1, this should be considered the 30-day notice of a change to the 2019 Medicare physician fee schedule scheduled for April 1, 2019.
More information is available in MLN Matters® article MM11163.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for January 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for January 2019 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for December 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for December 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for November 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for November 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for October 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for October 2018 are now available. Please take time to review these errors and avoid them on future claims.
The December Calendar of Events is now available. Visit the Education Center of our website for additional information and registration opportunities.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for September 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for September 2018 are now available. Please take time to review these errors and avoid them on future claims.
The Medicare October-November 2018 Calendar of Events is currently available for your reading pleasure. Please visit the Education Center of our webpage for additional information and registration opportunities.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for August 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for August 2018 are now available. Please take time to review these errors and avoid them on future claims.
Based on the implementation of the IOCE specifications from Change Request (CR) 10699, for claims received on or after July 1, 2018, regardless of the date of service, Critical Access Hospitals (CAHs) and Indian Health Service (IHS) hospitals that previously were not subject to NCCI edits '20' (W7020) and '40' (W7040) are now subject to these edits. Review the article for details.
The September 2018 Calendar of Events is now available for your immediate review. Visit the Education page of our website for additional information and registration opportunities.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for July 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for July 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for June 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for June 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for May 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for May 2018 are now available. Please take time to review these errors and avoid them on future claims.
Our downloadable data files have been updated to reflect the July MPFSDB update. The left column of our fee schedule search tool allows you to search for individual codes. Download complete fee schedules using the right column.
The 2018 June Calendar of Events is now available for your reading pleasure! Please visit the Education and Training page of our website for additional information and registration opportunities.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for April 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for April 2018 are now available. Please take time to review these errors and avoid them on future claims
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for March 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for March 2018 are now available. Please take time to review these errors and avoid them on future claims.
Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2018 (Change Request (CR) 10511), published on March 2, 2018, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates of service on or after January 1, 2018. Mass adjustments on previously paid 2018 claims began on April 9, 2018. The new rates are listed below.
Lower 48 States
Medicare Inpatient Ancillary Part B - $740
Medicare Outpatient per Visit Rate - $383
Alaska
Medicare Inpatient Ancillary Part B - $1,061
Medicare Outpatient per Visit Rate - $595
Checkout the new update to the 2018 I.H.s. Calendar of Events.
Don't miss your opportunity to get I on additional education and training. Visit the Education and Training page of our website for additional information and registration opportunities.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for February 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for February 2018 are now available. Please take time to review these errors and avoid them on future claims.
The March 2018 Part A Calendar of Events is available for your immediate review. Visit the Education and Training page of our website for additional information and registration opportunities.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for January 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for January 2018 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for December 2017 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for December 2017 are now available. Please take time to review these errors and avoid them on future claims.
Novitas is aware that the IHS Reimbursement Rates for Calendar Year 2018 have been published in the Federal Register; however, until we receive a Change Request (CR) from the Centers for Medicare & Medicaid Services with guidance on implementing the new rates, we will continue to process claims with the 2017 rates. Once we receive the CR, we will post the information to our IHS website and notify you via our listserv.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for November 2017 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part B Top Claim Submission / Reason Code Errors and resolutions for November 2017 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for October 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for October 2017 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission / Reason Code Errors and resolutions for September 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for September 2017 are now available. Please take time to review these errors and avoid them on future claims.
Novitas Solutions is conducting an IHS Ask the Contractor Webinar. We will be reviewing topics of provider interest on: CERT errors, Electronic Data Interchange (EDI), enrollment reminders, Medicare updates, website improvements, and upcoming education. We look forward to your participation!
The Top Claim Submission / Reason Code Errors and resolutions for August 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for August 2017 are now available. Please take time to review these errors and avoid them on future claims.
The 2017 September and October Calendar of Events is currently available for your viewing pleasure. Visit the Education and Training page of our website to review and register for your Fall sessions. You do not want to miss any of the great educational opportunities coming! Remain compliant and up to date with the Medicare program, register today.
The Top Claim Submission / Reason Code Errors and resolutions for July 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for July 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for June 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for June 2017 are now available. Please take time to review these errors and avoid them on future claims.
This instructor led workshop explores various Medicare topics such as provider enrollment requirements, patient screening tools, proper billing guidelines, Medicare changes, and more. The workshop offers a focused overview of Part A and Part B services that are referenced in the IHS Training Manual, navigation and utilization of the website, and a synopsis of Novitas initiatives.
The Top Claim Submission / Reason Code Errors and resolutions for May 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for May 2017 are now available. Please take time to review these errors and avoid them on future claims.
Join us for the October 26, 2017 Indian Health Services 2017 Workshop. Visit the IHS/Tribal/Provider's Education and Training page of our website for additional information and registration opportunities. You don't want to miss this event.
The Part B Top Claim Submission / Reason Code Errors and resolutions for March 2017 are now available. Please take time to review these errors and avoid them on future claims.
The September 2017 Indian Health Services Workshop date and location has been added. The workshop offers a focused overview of Part A and Part B services that are referenced in the IHS Training Manual, navigation and utilization of the website, and a synopsis of Novitas initiatives. Register today to attend this free workshop.
Per Change Request (CR) 9991, the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate were updated for dates-of-service on or after January 1, 2017.
All claims were identified and the adjustments to these claims started March 20, 2017.
Change Request (CR) 9991: “Indian Health Services (IHS) Hospital Payment Rates for Calendar Year 2017” published on March 10, 2017, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2017. Mass adjustments on previously paid 2017 claims will start in the near future. An update will be provided when the adjustment process has been initiated.
The new rates are:
Lower 48 States
Medicare Inpatient Ancillary Part B $679
Medicare Outpatient per Visit Rate $349
Alaska
Medicare Inpatient Ancillary Part B $1,046
Medicare Outpatient per Visit Rate $577
For additional information refer to CR9991.
The Top Claim Submission / Reason Code Errors and resolutions for February 2017 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for February 2017 are now available. Please take time to review these errors and avoid them on future claims.
Join Novitas Solutions for their annual Indian Health Services (IHS) Medicare workshop. This workshop offers a focused overview of Part A and Part B services. This is a free full day workshop dedicated to providing you the knowledge necessary to be a successful IHS provider. Register today.
Our Part A Top Inquiries FAQs have been reviewed for January 2017 with new questions added to the Appeals and General Information categories. Please take time to review these and other FAQs for answers to your questions.
The 2017 March Calendar of Events is now available for your viewing pleasure! Take the time to review the Education and Training page of our website for additional information and registration opportunities.
The Part B Top Claim Submission / Reason Code Errors and resolutions for January 2017 are now available. Please take time to review these errors and avoid them on future claims.
The correction for the negative reimbursement issue was successfully installed on January 23, 2017. All claims that were being held in status location SMIHSC with reason code 7IHSC have been released for processing. Any claims that were incorrectly processed before the holding of claims will be identified and reprocessed. No provider action will be needed.
The 2017 IHS Ask-the-Contractor meeting dates are now available. Mark your calendar to join us at the next Ask-the-Contractor meeting.
The Top Claim Submission / Reason Code Errors and resolutions for December 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for December 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Part A Top Claim Submission / Reason Code Errors and resolutions for November 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission / Reason Code Errors and resolutions for November 2016 are now available. Please take time to review these errors and avoid them on future claims.
On November 7, 2016, we published an alert about an issue that was identified with the IHS CAH claims (TOB 85x) receiving a negative reimbursement amount. We are still holding the outpatient claims (TOB 85x) in status location SMIHSC with reason code 7IHSC. The Fiscal Intermediary Shared System (FISS) has identified the problem and created a correction that is tentatively scheduled to be installed on January 23, 2017. Any claims that processed prior to the claims being held will be identified and reprocessed when a correction is installed.
Should it become necessary for any IHS CAH provider to request an accelerated payment due to a financial hardship, please visit the following link to our Medicare Overpayments Page and scroll to the instructions at the bottom of the page about “Accelerated Payment- Part A Only.”
The December 2016 IHS Calendar of Events has been posted. Please visit the calendar for additional information and registration opportunities.
The Part B Top Claim Submission / Reason Code Errors and resolutions for October 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Part A Top Claim Submission / Reason Code Errors and resolutions for October 2016 are now available. Please take time to review these errors and avoid them on future claims.
An issue has been identified with the IHS CAH claims (TOB 85x) receiving a negative reimbursement amount. This is causing payment problems and may be showing as withholdings on the remittance advice. Novitas has escalated the issue as a high priority and we will provide additional information as soon as it becomes available. Once the issue has been identified and corrected we will identify and correct all impacted claims.
Update 11/9/16: We will be holding the IHS CAH outpatient claims (TOB 85x) in status location SMIHSC with reason code 7IHSC until a correction to the negative reimbursement issue is installed. The Fiscal Intermediary Shared System (FISS) has identified the problem and a correction is being created. Any claims that processed prior to the claims being held will be identified and reprocessed when a correction is installed.
The Top Claim Submission / Reason Code Errors and resolutions for September 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for September 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for August 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for August 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for July 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for July 2016 are now available. Please take time to review these errors and avoid them on future claims.
The August 2016 Educational Events Calendar is now available! Please take a moment to review and register for upcoming events.
The Top Claim Submission / Reason Code Errors and resolutions for June 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for June 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for May 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for May 2016 are now available. Please take time to review these errors and avoid them on future claims.
Per CR9621, the acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate were updated for dates of service 2016.
All claims were identified and the adjustments to these claims started May 27, 2016, and the last of the claims that needed to be adjusted were initiated last night. All claims that needed to be reprocessed with the 2016 AIR rates have been completed.
We have added an additional session to our Indian Health Services (IHS) Calendar of Events. Join us on June 10, 2016 at 1:00 PM CT for the "IHS Top Claim Errors - Second Quarter 2016" webinar. Visit the Education and Training page of our website for additional information and registration.
The Top Claim Submission / Reason Code Errors and resolutions for April 2016 are now available. Please take time to review these errors and avoid them on future claims.
The Top Claim Submission / Reason Code Errors and resolutions for April 2016 are now available. Please take time to review these errors and avoid them on future claims.
Change Request (CR) 9621: “IHS Hospital Payment Rates for Calendar Year 2015” published on April 22,2016, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2016.
Novitas is in the process of updating the claim-payment system with the new rates. Mass adjustments on previously paid 2016 claims will start in the near future. An update will be provided when the adjustment process has been initiated.
The new rates are:
Lower 48 States
Medicare Inpatient Ancillary Part B $637
Medicare Outpatient per Visit Rate $324
Alaska
Medicare Inpatient Ancillary Part B $1,082
Medicare Outpatient per Visit Rate $582
For additional information refer to CR9621.
Join Novitas Solutions for their annual Indian Health Services Medicare educational event: Proper Billing of Indian Health Services (IHS) 2016 Workshop! Learn what is changing and trending now in Medicare. This year we are offering a full-day comprehensive workshop dedicated to providing you with the knowledge necessary to be a successful IHS Medicare provider. Participants will learn the basics of the Medicare program, how to bill Medicare correctly, and learn the latest Centers for Medicare & Medicaid Services (CMS) and Novitas Solutions initiatives. The all-day workshop is dedicated to help providers avoid the pitfalls and remain compliant with the Medicare program.
Registration is open for the following events:
May 26 – Albuquerque, NM
July 7 – Billings, MT
July 21 – Portland, OR
August 11 – Bemidji, MN
September 14 – Ada, OK
October 6 – Gallup, NM
Registration closes two business days prior to the event, so register early to reserve your seat.
The Top Claim Submission / Reason Code Errors and resolutions for March 2016 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for March are now available. Please take a moment to review these errors and avoid them on future claims.
We've added an additional event to our 2016 IHS Calendar of Events. This "Ask-the-Contractor" teleconference will take place on May 24th. Registration is now available.
Part B Top Claim Submission Errors and resolutions for February are now available. Please take a moment to review these errors and avoid them on future claims.
The Top Claim Submission Errors and resolutions for February 2016 are now available. Please take time to review these errors and avoid them on future claims.
Registration is now available for the following Proper Billing of Indian Health Services (IHS) 2016 Workshops:
March 17, 2016 – Anchorage, AK
March 18, 2016 – Bethel, AK
April 20, 2016 – Phoenix AZ
July 7, 2016 – Billings, MT
July 21, 2016 – Portland, OR
August 11, 2016 – Bemidji, MN
September 14, 2016 – Ada, OK
Please take a moment to review our 2016 IHS Medicare Workshop brochure for details about the workshops and then register for an upcoming event near you! In order to register for this year’s workshops, you will need a Novitas Medicare Learning Center account.
Registration for other workshops in 2016 will be available soon!
Meeting minutes from the February 9, 2016 Indian Health Services (IHS)/Tribal/Urban Indian Providers Ask-the-Contractor Teleconference (ACT) are now available! Please take a moment to review.
The Top Claim Submission Errors and resolutions for January 2016 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for January are now available. Please take a moment to review these errors and avoid them on future claims.
CMS updated the 2016 fee schedules in early January. If you downloaded or checked rates before January 11, 2016 you may want to double check those rates. This only affects 2016 dates of service. Claims will be paid correctly, using the updated fee schedule.
Use our convenient Fee Schedule Lookup and Download Tool to check rates individually, or download the full 2016 schedule.
The Top Claim Submission Errors and resolutions for December 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for December are now available. Please take a moment to review these errors and avoid them on future claims.
The Calendar of Events for February 2016 is now available! Please take a moment to review and register for our upcoming Ask-the-Contractor Teleconference on February 9, 2016.
The Top Claim Submission Errors and resolutions for November 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for November are now available. Please take a moment to review these errors and avoid them on future claims.
The Top Claim Submission Errors and resolutions for October 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for October are now available. Please take a moment to review these errors and avoid them on future claims.
The Top Claim Submission Errors and resolutions for September 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for September are now available. Please take a moment to review these errors and avoid them on future claims.
All of the claims that needed to be reprocessed with the 2015 AIR rates have been completed.
Change Request (CR) 9206: “IHS Hospital Payment Rates for Calendar Year 2015” published on July 10, 2015, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2015.
The Calendar of Events for November and December is now available! Please take a moment to review and register for upcoming events.
The Top Claim Submission Errors and resolutions for August 2015 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors for August 2015 are now available. Please take time to review these errors and avoid them on future claims.
Novitas has identified all of the claims that need to be reprocessed with the 2015 AIR rates. The adjustment process has started and will continue to occur over the next two weeks. We will post a final notification when all the adjustments are completed.
Change Request (CR) 9206: “IHS Hospital Payment Rates for Calendar Year 2015” published on July 10, 2015, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2015.
The Top Claim Submission Errors and resolutions for July 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for July are now available. Please take a moment to review these errors and avoid them on future claims.
The Second Quarter 2015 Report of Common Comprehensive Error Rate Testing (CERT) Indian Health Service Errors is Now Available. Learn more about the top CERT claims errors and how you can avoid these errors in your facility or practice.
If you have comments or questions about the report, please email QuestCERT@novitas-solutions.com. We value your feedback.
Change Request (CR) 9206: “IHS Hospital Payment Rates for Calendar Year 2015” published on July 10, 2015, revised the IHS acute care hospital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2015.
Novitas is in the process of updating the claim-payment system with the new rates. Mass adjustments on previously paid 2015 claims will start in the near future. An update will be provided when the adjustment process has been initiated.
The new rates are:
Lower 48 States
Medicare Inpatient Ancillary Part B $516
Medicare Outpatient per Visit Rate $307
Alaska
Medicare Inpatient Ancillary Part B $956
Medicare Outpatient per Visit Rate $564
For additional information refer to CR9206.
The Top Claim Submission Errors and resolutions for June 2015 are now available. Please take time to review these errors and avoid them on future claims.
Part B Top Claim Submission Errors and resolutions for June are now available. Please take a moment to review these errors and avoid them on future claims.
The IHS Educational Events Calendar for August and September 2015 is now available! Please take a moment to review and register for upcoming events.
NOTE: Please log into the Novitas Medicare Learning Center to join webinars at least 15 minutes prior to the event start time.
The Top Claim Submission Errors and resolutions for May 2015 are now available. Please take time to review these errors and avoid them on future claims.
Meeting minutes from the May 18 Indian Health Services (IHS)/Tribal/Urban Indian Providers Ask-the-Contractor Teleconference (ACT) are now available! Please take a moment to review.
Part B Top Claim Submission Errors and resolutions for May are now available. Please take a moment to review these errors and avoid them on future claims.
Novitas Solutions is pleased to bring a new quarterly report of CERT errors that is specific to Indian Health Service providers. This new report includes error types and reviewer comments. This report covers the first quarter of 2015.
If you have comments or questions about this report, please email QuestCERT@novitas-solutions.com. We value your feedback.
The Top Claim Submission Errors and resolutions for April 2015 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors and resolutions for April are now available. Please take a moment to review these errors and avoid them on future claims.
The Educational Events Calendars for May and June are now available! Please take a moment to review and register for an upcoming event!
The Top Claim Submission Errors and resolutions for March 2015 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors and resolutions for March are now available. Please take a moment to review these errors and avoid them on future claims.
The 2015 IHS Medicare Workshop in Anchorage, AK has been updated. The date of this event has changed from April 15th to May 28th. The location of the event will remain the same.
If you have already registered for this event, you will automatically be enrolled for the May 28th date.
Registration is now available for the following locations:
03/26/2015 – Phoenix, AZ
04/15/2015 – Anchorage, AK NOTE: NEW DATE May 28th
05/20/2015 – Portland, OR
06/17/2015 – Ada, OK
06/24/2015 – Albuquerque, NM
07/07/2015 – Aberdeen, SD
07/09/2015 – Bemidji, MN
08/19/2015 – Navajo Area (Gallup, NM)
09/16/2015 – Tucson, AZ
Please take a moment to review our 2015 IHS Medicare Workshop brochure for details about the workshops and then register for an upcoming event near you! In order to register for this year’s workshops, you will need a Novitas Medicare Learning Center account.
The Top Claim Submission Errors and resolutions for February 2015 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors and resolutions for February are now available. Please take a moment to review these errors and avoid them on future claims.
The Indian Health Service (I.H.S.) Ask-the-Contractor Teleconference (ACT) minutes for the February 10, 2015 meeting have been posted. Please take a moment to review.
Registration is now available for the following 2015 IHS Medicare Workshops:
March 3, 2015 – Billings, MT
March 26, 2015 – Phoenix, AZ
April 15, 2015 – Anchorage, AK
May 20, 2015 – Portland, OR
Please take a moment to review our 2015 IHS Medicare Workshop brochure for details about the workshops and then register for an upcoming event near you! In order to register for this year’s workshops, you will need a Novitas Medicare Learning Center account.
Registration for other workshops in 2015 will be available soon!
The Part B Top Claim Submission Errors and resolutions for January are now available. Please take a moment to review these errors and avoid them on future claims.
To ensure that you have the most accurate information, we have recently updated the IHS Manual. Please visit the Novitas Solutions website to view the updated manual.
Novitas Solutions is pleased to bring a new quarterly report of CERT errors that is .ecific to Indian Health Service providers. This new report includes error types and reviewer comments. This report covers the fourth quarter of 2014.
If you have comments or questions about this report, please email QuestCERT@novitas-solutions.com. We value your feedback.
The IHS Part A Top Claim Submission Errors and resolutions for January 2015 are now available. Please take time to review these errors and avoid them on future claims.
The 2015 Indian Health Services (IHS) Face-to-Face Workshops are now available. Please refer to this link to register for the events.
You will need to set up an account in the Novitas Medicare Learning Center in order to register for the event, receive the handouts and CEUs.
Registration will begin at 8:00am with the class running from 8:30am until 4:00pm.
Topics to be discussed include
Medicare overview and updates
Enrollment
UB billing for outpatient and inpatient
Part A billing errors
1500 claim billing for Part B services
Part B billing errors
Must attend the entire day to receive the CEUs.
The IHS Events Calendar for February and March is now available! Please take a moment to review.
The Part B Top Claim Submission Errors and resolutions for December 2014 are now available. Please take a moment to review these errors and avoid them on future claims.
he IHS Part A Top Claim Submission Errors and resolutions for December 2014 are now available. Please take time to review these errors and avoid them on future claims.
The Centers for Medicare & Medicaid Services (CMS) has announced an important change regarding the review and approval of Investigational Device Exception (IDE) submissions. Information regarding this change can be found on our Clinical Trials and Devices web page.
The Part B Top Claim Submission Errors and resolutions for November 2014 are now available. Please take a moment to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission Errors and resolutions for November 2014 are now available. Please take time to review these errors and avoid them on future claims.
Have you completed a website satisfaction survey this month? Novitas Solutions randomly offers our customers a website satisfaction survey [which we encourage you to take every 30 days] that gives you a direct line to provide your feedback. Tell us how you feel about our recent website design changes. How about your thoughts on our NEW Fee Schedule Tool? Are there other enhancements we could make to our website? Each survey completed is reviewed by a team of experts, who continually look for ways to improve your web experience.
Your opinion matters and we want to hear it. We look forward to hearing from you soon.
Here's what the satisfaction survey looks like:
You asked and we delivered! We are happy to announce the new and improved Medicare Physician’s Fee Schedule Code Search & Downloads! No more searching in multiple places to find what you’re looking for. This is a one-stop shop for all your fee schedule needs. Attached are instructions with screen images to help you navigate.
Note: The 2015 fees for single code searches will not be available until January 2015. However, the 2015 fee schedule is available through the Download option.
The IHS Part A Top Claim Submission Errors and resolutions for October 2014 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors and resolutions for October 2014 are now available. Please take a moment to review these errors and avoid them on future claims.
Handout materials are now available for the IHS Face-to-Face Workshop in Nashville, TN on November 13, 2014.
Register today to attend this event!
Join us for the next I.H.S. Ask the Contractor Teleconference (ACT). During this teleconference we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Novitas Solutions.
Please take a minute to review information regarding local contractor pricing of procedure code 75946.
The Part B Top Claim Submission Errors for September 2014 are now available. Please take time to review these errors and avoid them on future claims.
The IHS Part A Top Claim Submission Errors and resolutions for September 2014 are now available. Please take time to review these errors and avoid them on future claims.
We added two new questions to the Novitas Medicare Learning Center FAQs, “I tried to log into my account and it's locked, why?” and “How do I unlock my account?” We also clarified a few others. Check out the answer to these and other questions about the Novitas Medicare Learning Center.
As the leaves change color, so will the look of the Novitas Solutions website. Based on your feedback and organization of content, we are pleased to announce a new look and layout coming September 29. With this new look, bookmarks may need updated.
Some of the enhancements include:
Selecting the Line of Business (Part A or Part B) remembers your choice between sessions
Accepting the Disclaimer only once per visit
Rolling Banner for Hot Topics
Quick Links at the top and bottom of each page
Drop down box to search Entire Site or Medical Policy/LCD
Navigation improvements
The November and December Indian Health Services (IHS) Events Calendar has been posted to the website! Please take a moment to review and register for upcoming events!
The IHS Part A Top Claim Submission Errors and resolutions for August 2014 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors for August 2014 are now available. Please take time to review these errors and avoid them on future claims.
Change Request (CR) 8763: “IHS Hosital Payment Rates for Calendar Year 2014” published on May 23, 2013, revised the IHS acute care hosital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2014.
Novitas has completed all claim adjustments for the 2014 AIR rates.
A new release of the Short-Term (ST) Acute Care Program for Evaluating Payment Patterns Electronic Report (PEPPER), with statistics through the second quarter of fiscal year 2014, is available for short-term acute care hositals nationwide.
Meeting minutes from the August 12 Indian Health Services (IHS)/Tribal/Urban Indian Providers Ask-the-Contractor Teleconference (ACT) are now available! Please take a moment to review.
Registration is now open for the upcoming I.H.S. How to Avoid Top Claim Errors webinar on September 16. Please register via the Novitas Medicare Learning Center.
The handout for the August IHS Face-to-Face Workshops is now available. If you have registered for an upcoming event in August, please bring the handout with you.
The Top Claim Submission Errors and resolutions for July 2014 are now available. Please take time to review these errors and avoid them on future claims.
The Part B Top Claim Submission Errors for July 2014 are now available. Please take time to review these errors and avoid them on future claims.
Novitas Solutions wants to ensure that you have the information you need to submit your claims correctly. The Top Claim Submission Errors and resolutions will now be posted monthly on our website. The Part B Top Claim Submission Errors for May 2014 are now available. Please take time to review these errors and avoid them on future claims.
The JH Part B Indian Health Service (IHS)/Tribal/Urban Indian Providers Ask-the-Contractor meeting minutes from May 13, 2014 are now available on our website!
The 2014 rates have successfully been loaded to the claim-payment system. We anticipate that all 2014 date of service claims, previously processed under the old rates, will be adjusted to reflect the new rates by August 31, 2014.
The Top Claim Submission Errors and resolutions for May 2014 are now available. Please take time to review these errors and avoid them on future claims.
Change Request (CR) 8763: “IHS Hosital Payment Rates for Calendar Year 2014” published on May 23, 2013, revised the IHS acute care hosital outpatient payment rate (All-Inclusive Rate (AIR)) and the inpatient ancillary Part B rate. This annual update is effective for dates-of-service on or after January 1, 2014.
Novitas is in the process of updating the claim-payment system with the new rates. Mass adjustments on previously paid 2014 claims will start in the near future. An update will be provided when the adjustment process has been initiated.
The new rates are:
Lower 48 States
Medicare Inpatient Ancillary Part B $502
Medicare Outpatient per Visit Rate $297
Alaska
Medicare Inpatient Ancillary Part B $862
Medicare Outpatient per Visit Rate $516
For additional information refer to CR 8763.
In addition to the recently announced enhancements to the Policy Search Application, a LCD/Policy Search link will replace the current Policy Search box located at the top of our web pages. This LCD/Policy Search link will take you directly to the LCD/Policy Search application. As previously announced this new search application allows you to search current, draft and retired LCDs. And, you get only the LCDs that match your search criteria.
The general Site Search box will no longer give LCD results. Therefore, if you are looking for a LCD, you must use the LCD/Policy Search application.
Stay tuned and visit the Novitas Solutions website for upcoming educational opportunities.
Registration is now open for the I.H.S. Face-to-Face Training in Tucson, AZ on August 20, 2014!
Novitas Solutions wants to ensure that you have the information you need to submit your claims correctly. The Top Claim Submission Errors and resolutions will now be posted monthly on our website. The Part A Top Claim Submission Errors for April 2014 are now available under the Claims and Billing section. The Part B Top Claim Submission Errors will be posted shortly. Please take time to review these errors and avoid them on future claims.
Novitas Solutions is pleased to announce its new customized “Policy Search Application” which will allow you to search by current, retired or draft policies. Yes, retired policies are coming back!
You may search multiple ways by:
Policy number (LXXXXX, DLXXXXX)
Current Procedural Terminology (CPT)
Healthcare Common Procedure Coding System (HCPCS)
Keyword
Local Coverage Determination (LCD) title
Search results will give you only the policies based on the search criteria entered.
Stay tuned and visit the Novitas Solutions website for upcoming educational opportunities and information.
Join us for the Indian Health Service (IHS)/Tribal/Urban Indian Providers Ask-the-Contractor Teleconference. During this teleconference, we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Novitas Solutions.
Representatives from various departments including Medical Policy, Medical Review, Appeals, Customer Service, Claims Processing, Provider Enrollment, Change Management, and our Outreach and Education Staff will be available to address your questions and concerns.
You do not want to miss this call! Register Today!
The Indian Health Service (IHS) Event Calendar has been updated with Hotel and Registration information for the IHS Face to Face Workshops being held in Albuquerque, NM on April 16, 2014 and Church Rock, NM on August 14, 2014. Please take a moment to review the calendar.
Please read this important article about development requests for additional information on your Provider Enrollment applications. We are noticing trends in missing data on the various CMS 855 enrollment applications, and it is causing delays in processing your application. Did you miss one of these required items?
The Indian Health Services Ask-the-Contractor Teleconference meeting minutes from February 11, 2014 are now available on our website!
Novitas Solutions would like to remind our providers about hardcopy claim adjustments and cancels, the ability to submit adjustments and cancels electronically on claims that include denied services (without altering the denied item) and the importance of including Remarks.
Join us for our workshop on February 27, 2014 in Tulsa, OK. This event will be held at the Hilton Garden Inn Tulsa Midtown.
Hilton Garden Inn
Tulsa Midtown
4518 E Skelly Drive
Tulsa, OK, 74135
Register today for this in person event! Or check out other upcoming events here
The Guidelines for Billing Acute Inpatient Noncovered Days bulletin has been revised to include instructions for the use of occurrence .an code M1 to report provider liable days. Occurrence .an code M1 replaces occurrence .an code 77. Please begin using occurrence .an code M1 to report provider liable days.
This new resource has been added to the Indian Health Service (IHS) Center under the Claims and Billing section. Click the following link to view the IHS Coverage and Billing Requirements for MNT and DSMT services.
Updated 01/27/2014 1:44 PM
Novitas has identified the IHS billers impacted by the incorrectly denied RRB HIC numbers that occurred during the last two weeks of October 2013. Impacted providers have been identifed through an internal report and we are manually working through this process. If providers choose to expedite this process, claims denied with MCS msg: CO-140 (Patient/insured health identification number and name do not match) can be resubmitted.
Novitas has identified a claims processing issue with claims that might have been incorrectly denied due to Railroad Board (RRB) for HIC numbers submitted during October 2013. These claims can be identified with the following denial msg: CO-140 (Patient/insured health identification number and name do not match). Novitas is currently researching the issue and once corrected, will identify and correct any impacted claims. Updates will be made to this notice as additional information is identified. We apologize for any inconvenience this has caused.
Join us for our "Indian Health Services (IHS) Ask-the-Contractor Teleconference" on February 11, 2014 (1:00pm-2:30pm CT, 2:00pm-3:30pm ET). During this teleconference, we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Novitas Solutions. Register for this informative teleconference today.
Archived Indian Health Service News - 2013
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