On Demand Training Available At Your Convenience

On Demand Training Available At Your Convenience

WPS Medicare understands that a provider's office is a busy place. With this in mind, WPS Medicare would like to bring the education to you. We are proud to offer On Demand training on a variety of topics to our provider community. To access our On Demand Training web page, hover over the Training tab on any web page and select "On Demand Training" from the drop down menu.

 

Administrative Simplification Compliance Act (ASCA) Denials Have No Appeal Rights

Administrative Simplification Compliance Act (ASCA) Denials Have No Appeal Rights

Claims denied with a Medicare Remittance Advice message M117, "Not covered unless submitted via electronic claims," are not considered an initial determination. Therefore, claims with this denial message do not have an appeal right. The ASCA requires that providers submit claims to Medicare electronically, with a limited number of exceptions. Do not request an appeal. These services must be resubmitted electronically to be considered for payment. For additional information on ASCA please refer to "Administrative Simplification Compliance Act (ASCA)."

 

Claims Denied Based on the Timely Filing Limit Do Not Have Appeal Rights

Claims Denied Based on the Timely Filing Limit Do Not Have Appeal Rights

When a claim is denied for having been filed after the timely filing period (12 months or 1 calendar year), such denial does not constitute an "initial determination." As such, the determination is not subject to appeal. Appeal requests will be dismissed due to no initial determination. For additional information on timely filing requirements or potential reasons for extending this timeframe, please refer to "Timely Filing of Claims."

 

Did You Know there is now a CMS Secure Net Access Portal (C-SNAP) Manual?

Did You Know there is now a CMS Secure Net Access Portal (C-SNAP) Manual?

The manual for C-SNAP offers quick and easy steps to perform various functions, such as registering for a C-SNAP user ID, checking patient eligibility, status on a claim, status on a Part A or Part B appeal, and much more! The manual was created to assist users with all functions within the tool. To view the manual, please visit C-SNAP and select the User Manual link on the left hand navigation of the web page.

 

On Demand Training ASCA Denials Late Filed Claims C-SNAP

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