Medicare Compliance & Reimbursement
Top Claims Issue for MAC — Too Many Claims Under Medical Review
If you’re wondering what’s taking your claim so long to process, it may be stuck in a claims-review log jam. According to Medicare Administrative Contractor (MAC) Palmetto GBA, the MAC’s top processing issue: too many claims for medical review. The problem titled “High Volume of Pending Claims Requiring Medical Review” has been ongoing since October, the MAC suggest. “Palmetto GBA is experiencing a high volume of pending workload for claims that require clinical review,” says the MAC. Reasons for the backlog and need for the claims to be reviewed include: “Unclassified procedure codes that need an operative report; claims requiring a coverage decision; [and] claims that need additional documentation.” See Palmetto GBA’s release on the issue at www.palmettogba.com/palmetto/providers.nsf/docsCat/Providers~JM%20Part B~Browse by Topic~Claims Processing Issues Log?open&Cat=Current Issues
Medicare Compliance & Reimbursement
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Top Claims Issue for MAC — Too Many Claims Under Medical Review
If you’re wondering what’s taking your claim so long to process, it may be stuck [...]
