Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. Timely Filing - View timely filing requirements for claim submission.Submit claims and inquiries to Palmetto Government Benefits Administration Railroad Medicare - When a beneficiary's Medicare card shows an alpha-prefix instead of a suffix, patient is eligible for Railroad Retirement benefits Medicare Part B.PWK (Paperwork) - PWK is a segment within 837 Professional and Institutional electronic transactions which provides ‘linkage' between electronic claims and additional documentation necessary for claims processing.Professional Provider Telecommunications Network (PPTN) - Allows providers to access beneficiary eligibility, claim status, summary of claim volume and payments, pricing information and diagnosis and procedure code lookups. National Correct Coding Initiative (NCCI) Edits - Access code pairs that should not be reported together for a number of reasons.Modifier and HCPCS Changes - View new and deleted National Level II modifiers and HCPCS codes.Miscellaneous Services and Charges - View various miscellaneous service topics and related charges.It fills in some "gaps" in Medicare coverage Medigap - Health insurance policy offered by a private entity to persons entitled to Medicare benefits and is designed to supplement Medicare benefits.A randomly generated MBI will replace SSN-based Health Insurance Claim Number on new Medicare cards Medicare Beneficiary Identifier (MBI) - Congress requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019.Medically Unlikely Edits (MUEs) - Maximum number of units of service, per HCPCS/CPT, a provider can report for a beneficiary on a date of service.Mandatory Claim Submission - Providers and suppliers must submit Medicare claims for all covered services on behalf of Medicare beneficiaries.Eligibility and Entitlement for Persons with Medicare - View how different patient programs affect a beneficiary.Electronic Submission of Medical Documentation (esMD) - This Medicare pilot project gives some providers a new mechanism for submitting medical documentation to review contractors.Denial Code Resolution - View common claim submission error codes, descriptions of issues, and potential solutions.Claims Processing Timeliness Interest Rate - If payment is not made within 30 days (ceiling period) after date of receipt, interest must be paid on clean claims.
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