Public Insurer Relations
(Centers for Medicare & Medicaid Services – CMS)

Engage in Initiatives to Report on Quality

• Physician Quality Reporting System (PQRS)
• AAN Quality Measures Page

Make the Decision to Participate

• Identify my Part A/B Medicare Administrative Contractor (MAC) (.pdf)
• Provider Enrollment, Chain, and Ownership System (PECOS) Provider Enrollment, Chain, and Ownership System (PECOS)
  • Don't Forget to Enroll in PECOS by January 3, 2011!
  • List of Referring and Ordering Physicians in PECOS is now Available Online
  • EHR Incentive Program Requires PECOS Enrollment
  • CMS Pushes Date By Which All Physicians Who Refer or Order Must be Enrolled in PECOS to January 3, 2011
  • Academy Urges CMS to Push Back PECOS Enrollment Date
  • Medicare Enrollment Update for Referring Ordering Physicians: PECOS
  • Communicating Issues in the Medicare Enrollment Process
  • Find Additional Resources on CMS's PECOS page
• Participation/Non-Participation/Private Contracting Participation/Non-Participation/Private Contracting
  • Know Your Medicare Participation Options
  • CMS Releases Enrollment Guidance for Physicians that Infrequently Receive Reimbursement from the Medicare Program
  • Tips to Facilitate the Medicare Enrollment Process (.pdf)
• Current Medicare Contractor Provider Satisfaction Survey (MCPSS)

Conquer Insurer Audits

• Recovery Audit Contractors (RACs) Recovery Audit Contractors (RACs)
  • Learn About RACs (.pdf)
  • Find my RAC
  • Paperwork, Timing are Essential when Appealing RAC Audit (May 2010, page 7, .pdf)
  • Must-Have Information to Prepare for Possible RAC Audit (April 2010, page 12, .pdf)
  • RACs Become a Reality
  • Neurologists to Medicare: Modify Audit Program
• How to Perform a Physician Practice Internal Billing Audit (.pdf)
• How to Prepare for an Health Insurer Retrospective Audit (.pdf)

Appeal Medicare Claim Denials

• How To Appeal a Medicare Claim Denial (.pdf)
• The Medicare Appeals Process: Five Levels to Protect Providers, Physicians, and Other Suppliers (.pdf)

Network with Colleagues in your State

• Neurology Carrier Advisory Committee (NeuroCAC) Neurology Carrier Advisory Committee (NeuroCAC)
  • Find out who the NeuroCAC Representative is in your state
  • Q&A document about the NeuroCAC (.pdf)
  • Search and view carrier Local Coverage Determinations (LCDs)
  • Carrier Advisory Committee Needs Neurologists' Input (May 2009, page 5, .pdf)
• State Neurology Societies

Additional Resources

• Red Flags Rule
• Stark Law – What Neurologists Need to Know
• CMS Resources CMS Resources
  • Sign up to Receive Regular CMS Correspondence
  • Medicare Learning Network: CMS National Educational Products
  • National Provider Identifier (NPI) Registry
• Medicare Part D
• Independent Testing Facilities (IDTF) (.pdf)

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