MAC Jurisdiction 8 Implementation to Start

MAC Jurisdiction 8 Implementation to Start

CMS recently instructed WPS to begin the implementation of MAC Jurisdiction 8. For this contract, WPS will administer the Part A and Part B benefits for Indiana and Michigan. While specific timelines are not yet available, WPS is already working to ensure a smooth and seamless implementation.

As more information becomes available, we will use our website, eNews, and other distribution channels for updates. WPS looks forward to serving the Jurisdiction 8 beneficiaries and provider community.

 

Redesigned Claims Area

Redesigned Claims Area

In an effort to improve your website experience, we have recently redesigned the Claims area of our website. You can now access information on claims submission, claims processing, claim denials, and claim rejections by selecting the "Claims" tab from the top navigation. Please note, you may have to recreate any bookmarks you had saved for claims-related information.

 

Is your vendor, billing service, or clearinghouse ready for 5010?

Is your vendor, billing service, or clearinghouse ready for 5010?

WPS Medicare maintains a listing of contact information for vendors, Network Service Vendors (connectivity vendors), billing services, and clearinghouses that have tested their product/service with Medicare and have been approved for format 5010. We encourage you to access this listing by visiting our website(external link) and selecting Electronic Media Claims Approved Vendors, Billing Services, and Clearinghouses on the right hand side of the page.

 

Duplicate Appeal Requests

Duplicate Appeal Requests

WPS Medicare has seen an increase in the number of duplicate appeal (redetermination) requests. Medicare contractors have 60 days to complete an appeal request. Please do not submit duplicate appeal requests, as they represent unnecessary costs and duplicative efforts to both the Medicare Program and your office. For additional information, please refer to Duplicate Appeal Requests.

 

Multiple Procedure Payment Reduction

Multiple Procedure Payment Reduction

Medicare recently expanded the Multiple Procedure Payment Reduction (MPPR) to include the professional component of certain diagnostic imaging procedures. The MPPR applies to multiple designated services provided to a beneficiary by the same provider during the same session. The “59“ modifier may be used to identify services provided in different sessions.

 

MAC J8 Implementation Claims Tab 5010 Duplicate Appeal Requests MPPR

Tips for First Time Visitors

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Are you new to the WPS Medicare, MAC Part B website? If so, please allow us to introduce you to the site and the various tools we have available to assist you.

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C-SNAP

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WPS offers C-SNAP, a FREE 24/7 Internet portal that provides real-time patient eligibility and claim status information, the ability to view and print duplicate remittance advices on demand, and an avenue to submit appeal requests and review responses on line.

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CERT

Stop refunding money, WPS Medicare is dedicated to helping you receive correct payments and avoid errors that are identified by the Comprehensive Error Rate Testing (CERT) contractor.

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Evaluation and Management (E/M)

The most billed service to the Medicare Program is a "Patient Visit". When billing for this service the CPT code selected should be the one that best represents the level of service provided.

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The Site Map is a menu of the main pages on our website. It shows the overall website layout allowing providers to select any of the links for immediate access to a specific page. You can access the site map from the link in the upper right corner of any page.

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Visit the "Provider Specialties/Services" web pages to view information for over 20 specialties and services from Ambulance to Urology.

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