National Government Services, Inc. has a long history of supporting federal health agencies such as the CMS. Throughout the country, NGS has efficient operation, financial and human resources in place that position the organization as a national leader in Medicare for 55 years.

Our Mission: Improving Lives and Communities. Simplifying Healthcare. Expecting More.

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National Government Services, Inc. (NGS) serves as your Centers for Medicare & Medicaid Services (CMS) Medicare Administrative Contractor for Original Medicare Part A (hospital), federally qualified health centers (FQHCs)/rural health clinics (RHCs), home health and hospice (HH+H) and Part B (medical) services in our contracted states and territories. NGS processes claims, issues payment and provides customer service for those Medicare-enrolled providers; click the About Us link on our website for details.

The following resources will assist you in your claim submission(s):

Tools and Calculators
 Web Portal for Claim Information
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Short Educational Videos
The interactive voice response system (IVR) is available 24-Hours a day, seven days a week to answer general inquiries.
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Top Denial Hospice Claims

Has your hospice recently received a claim denial? Here are the top denial claims affecting hospice agencies in California. CHAPCA can help refer you to the appropriate education to help rectify these issues. 

Technical Denials

1. Invalid Hospice Election Statement:

  • Need to clearly identify the effective date of the election, which may be the first day of hospice care or a later date, but may be no earlier than the date of the election statement.  
  • Please reference the Hospice Notice of Election Statement sample in MLN Matters SE1631 Revised.

CHAPCA recommends:

Sharp Curves Ahead: Is Your Hospice Documentation & Practice Able to Withstand Audit Scrutiny?

2. Incomplete/Invalid Certification/Recertification's of Terminal Illness:

  • Untimely signed certifications of terminal illness (COTI) and missing the attending's COTI (if elected on Notice of Election Statement).

For the first 90-day period of hospice coverage, the hospice must obtain, no later than 2 calendar days after hospice care is initiated, (that is, by the end of the third day) oral or written certification of the terminal illness by the medical director of the hospice or the physician member of the hospice IDG, and the individual's attending physician if the individual has an attending physician. 

  • The certification of terminal illness is missing a valid statement directly above the physician signature attesting that by signing, the physician confirms that he/she composed the narrative based on his/her review of the patient's medical record or, if applicable, his or her examination of the patient. 

CHAPCA recommends:

2021 Hospice Billing Series: Hospice Billing Part 1 Eligibility Requirements & Notice of Election

Documentation does not support a terminal prognosis per the Local Coverage Determination (LCD) for Hospice - Determining Terminal Illness (L33393).

Provider should document clear, detailed information that is disease and/or non-disease specific showing a decline in clinical status to support a terminal illness of six months or less.

CHAPCA recommends: 

CHAPCA's Clinical vs. Terminal 4 Part Series covering tools (PPS, FAST, NYHA), Neurological Care, Cardiac Care, and Respiratory Care.

General Inpatient Services

General inpatient services are being billed after the beneficiary's symptoms have stabilized. The documentation and interventions need to show that general inpatient care is being provided in an inpatient facility for pain control or acute or chronic symptom management which cannot be managed in other settings.


How to Avoid the Top Five Survey Deficiencies & Denials

For a listing of the top Claim Errors in Hospice, click HERE.

Register Today for Home Health and Hospice Training Sessions

Registration is open for the following home health and hospice (HH+H) training opportunities. All HH+H providers are welcome to attend any training session. Click on the link for more information and registration.

Webinars, Teleconferences & Events



Hospice Documentation: Painting the Picture of the Terminal Patient

November 16, 2021 | 9:00-10:30 a.m.  

This webinar will provide detailed information to assist providers with a greater understanding of the federal Medicare hospice benefit regulations regarding medical record documentation that will support terminal prognosis. Additionally, this webinar will review responding to an ADR for current auditing procedures and provide an overview of current medical review auditing processes. Attendees will be offered up-to-date references and resources, as well as National Government Services contact information for future questions regarding Medicare regulations.

Who Should Attend

This session is designed for any and all staff who require comprehension of, or provide documentation within the medical record of the hospice beneficiary. Small providers are encouraged to attend this session as the topic and education format is appropriate for those provider types. 

Registration Information 

Preregistration for this free webinar session is mandatory. Space is limited. 

Once registration is completed, an email including instructions for accessing the event will be sent to the email address provided. You will need the link provided in the confirmation email in order to attend. Please do not share your link with others; it is unique to your registration. 

Additional Information

  • Number of CEUs and MUCs offered: 1 

2021 Virtual HHH MAC Collaborative Summit-Operation Collaboration: We are all in this Together 

The 2021 Virtual HHH MAC Collaborative Summit-Operation Collaboration: We are all in this Together encore playlist is now available on YouTube for viewing. The playlist includes NGS hosted sessions only. Unfortunately, sessions 14 & 17 are missing due to technical issues with the recordings.

Please see below for access and feel free to share the link your colleagues, staff and providers. The link will be available through November 25th only.