General

1. How do providers obtain overlapping claim information?
2. How does a provider request to have a suspended claim sent to the Return to Provider (RTP)?

1. How do providers obtain overlapping claim information?

   Providers who render recurring services on a monthly basis should request information about inpatient stays from their patients when the services are provided.  This will help decrease the number of overlapping claim rejections a facility receives.  However, if a claim is billed and is overlapping another facility's claim, the customer service representatives (CSRs) can provide overlapping claim information processed by any Medicare contractor.  For PA providers, please call 1-800-560-6170 and for MD/DC providers call 1-866-488-0545.  Also, CMS provides listings of provider numbers, provider names, addresses and the assigned Fiscal Intermediary. To access these listings, follow these instructions:

   a) Access The Centers for Medicare and Medicaid Services (CMS) website at www.cms.hhs.gov.

   b) Access 'Research, Statistics, Data & Systems

   c) Access Cost Reports under Files for Order

   d) Access whatever provider type on the left hand side

   e) Scroll down to Frequent Reports and select Provider ID Information

   Date Posted: 03/17/2008, Date Reviewed/Revised: 04/25/2008

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2. How does a provider request to have a suspended claim sent to the Return to Provider (RTP)?

   The Customer Service Representatives can RTP the suspended claim for correction, if appropriate.  For PA providers, please call 1-800-560-6170 and MD/DC providers call 1-866-488-0545.

   Date Posted: 04/25/2008

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