The Centers for Medicare & Medicaid Services (CMS) selected National Government Services as the new Medicare Administrative Contractor (MAC) for Part A/B Jurisdiction 6 (J6). The J6 service area includes Part A and Part B providers in the states of Illinois, Minnesota, and Wisconsin, and National Government Services current HH+H and federally qualified health center (FQHC) providers. National Government Services will assume responsibility for J6 A/B MAC workload in segments based on geographic location/outgoing contractor. J6 local coverage determinations (LCDs) will become effective for services rendered on or after the date a provider's segment transitions to J6.
Full Answer
What is J6 in Medicare?
Medicare. Medicare Administrative Contractors. Who are the MACs. Who are the MACs: A/B MAC Jurisdiction 6 (J6)
What is Medicare Part 6 jurisdiction?
A/B MAC Jurisdiction 6 – Home Health and Hospice Facts J6 processes FFS Medicare HH+H claims for Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Michigan, Minnesota, Nevada, New Jersey, New York, Northern Mariana Islands, Oregon, Puerto Rico, US Virgin Islands, Wisconsin and Washington.
What states are in Medicare jurisdiction K?
Jurisdiction K encompasses the states of Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island, and Vermont. The JK MAC is also responsible for processing Medicare Home Health and Hospice (HHH) billings in six states: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
What states are in Medicare Region C?
DME MAC Jurisdiction C – DME Facts JC processes FFS Medicare DME claims for Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, and West Virginia.
What Medicare jurisdiction is California?
Noridian Administrative Services LLC (NAS) administers Medicare health insurance for the Centers for Medicare and Medicaid Services (CMS) for Jurisdiction E.
What jurisdiction is New York for Medicare?
Jurisdiction KNational Government Services (NGS) administers Medicare health insurance for the Centers for Medicare & Medicaid Services (CMS) for Jurisdiction K which includes the State of New York.
What states are in jurisdiction A?
Jurisdiction A is serviced by Noridian Healthcare Solutions and includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.
What is the MAC locality?
However, the Medicare Administrative Contractors (MACs) have been allowed to process claims using what we refer to as the “locality rule”. The “locality rule” allows for when patients normally seek medical attention at a few regional hospitals on a regular basis.
What are the Medicare MACs?
A Medicare Administrative Contractor (MAC) is a private health care insurer that has been awarded a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or Durable Medical Equipment (DME) claims for Medicare Fee-For-Service (FFS) beneficiaries.
Why do I need Medicare Part C?
Medicare Part C provides more coverage for everyday healthcare including prescription drug coverage with some plans when combined with Part D. A Medicare Advantage prescription drug (MAPD) plan is when a Part C and Part D plan are combined. Medicare Part D only covers prescription drugs.
What states are in Medicare Region B?
DME MAC Jurisdiction B - DME FactsJB processes FFS Medicare DME claims for Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio and Wisconsin.Total Number of Fee-for-Service Beneficiaries: 6,148,172 (as of 9/30/2021)Total Number of Suppliers: 16,106 (as of 9/30/2021)More items...•
What are Medicare regions?
CMS Regional OfficesRegionRegional Office LocationContactRegion [email protected] 2New [email protected] [email protected] [email protected] more rows•Dec 1, 2021
How much is the J6 A/B MAC?
The total value of the contract for the five year period is approximately $277 million.
What is the first point of contact for Medicare?
A beneficiary’s first point of entry for resolution of questions about Medicare coverage will be 1-800-MEDICARE. The A/B MAC will handle only complex inquiries from beneficiaries.
Required Enrollment Process
The following process is required and must be completed prior to initiation of electronic claims submission or inquiry.
Waiting for a Response
After processing, a confirmation will be sent to you as notification to begin filing claims electronically. If neither confirmation nor a returned packet is received after two weeks, please contact the Technology Support Center toll-free at 1-877-273-4334.
Testing
Once you have received your Submitter ID and Password from NGS, please call the ClaimShuttle Support Team and set up an appointment for Mailbox setup and Test Transmission.
Current Maps and Lists
To find out who the current A/B and DME MACs are, use these maps and lists to help you determine which MAC is of most interest to you.
DME MACs
The DME MACs process Medicare Durable Medical Equipment, Orthotics, and Prosthetics (DMEPOS) claims for a defined geographic area or "jurisdiction," servicing suppliers of DMEPOS. Learn more about the DME MAC in each jurisdiction.
