Home Health & Hospice Week
Industry Note:
Skipping 1st Medicare Appeal Level Doesn't Get You Ahead
Published on Fri Jan 18, 2019
Don’t waste your appeals time and effort by falling into a common trap. The problem: “Recently, we have noticed an increase in the number of initial appeal requests sent as a Reconsideration before a Redetermination has been requested,” reports HHH Medicare Administrative Contractor CGS on its website. Medicare has five appeals levels, and Redetermination by the MAC is the first level. The solution: “When appealing our claim decisions … you must go through the appeal levels in order, starting with a Redetermination,” CGS instructs. More information, including an outline of the five appeals levels, is at https://cgsmedicare.com/hhh/pubs/news/2018/1218/cope10455.html.
Other Articles in this issue of
Home Health & Hospice Week
- Regulations:
HHAs Still Hanging On RCD
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You Have To Take A Hit For Falls At Doctor's Office, Elsewhere
CMS issues another OASIS-D question-and-answer set. Home health staff performing OASIS-D assessments are encountering confusion, [...] - Reimbursement:
MACs Issue Information On Advance Directive Procedure
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NOTR Problems Snarl Billing
New edit should clear up at least some problems occurring with transfer patients. Medicare officials [...] - Quality Reporting:
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Home Health Claims Lacking County Codes Bounce Back
Try this keying trick to get them through. Get up to speed on the new [...] - Industry Note:
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If you’re not yet using the new Medicare Beneficiary Identifier numbers contained on your patients’ [...] - Industry Note:
Skipping 1st Medicare Appeal Level Doesn't Get You Ahead
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