Ordering/Referring Denial Edits

Ordering/Referring Denial Edits

Effective January 6, 2014, the Centers for Medicare & Medicaid Services (CMS) turned on claim processing edits for the expansion of the scope of editing for ordering/referring providers to deny Part B diagnostic laboratory and imaging claims. Claims identified or defined as diagnostic laboratory and imaging services (i.e., EKGs) will deny if the ordering or referring provider’s information is missing, invalid or if the provider is not of a specialty that is eligible to order and refer. Claims submitted identifying the ordering or referring provider information missing the matching NPI will be rejected.

Additional information can be found in the MLN Matters Article SE1305.

Go Green! It's FREE!

Go Green! It's FREE

Trying to reduce paper and clutter? Why not obtain your remits electronically and have your Medicare payments electronically deposited to your financial institution? To learn more about how to receive electronic remittance advices (ERAs) and electronic funds transfer (EFT), please visit the Medicare EDI department page and select the “Go Green” URL located on the right under "Additional Links."


C-SNAP Passwords

C-SNAP Passwords

If your C-SNAP account becomes locked due to an incorrect password, select the Forgot Password link located on the C-SNAP Login screen. After entering the required elements, a temporary password will be emailed to you. Please contact your NPI C-SNAP Administrator for assistance with passwords.


Two New CMS Secure Net Access Portal (C-SNAP) Features Coming Soon!

Two New CMS Secure Net Access Portal (C-SNAP) Features Coming Soon!

Clerical Error Reopens: There will be a change to how reopening requests will be accepted by WPS Medicare via the C-SNAP. You will no longer have to complete the Reopening Request form, but rather you will have the opportunity to make an adjustment to your claim.

Overpayment Claim Adjustments: Medicare Part B providers will have an automated process to submit Medicare Secondary Payer (MSP) and non-MSP overpayment adjustments via C-SNAP.


Ordering/Referring Denial Edits Go Green C-SNAP Passwords C-SNAP

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