News You Can Use:
Learn 2 New CMS Appeal Thresholds Before Filing
Published on Tue Sep 22, 2009
CMS changes amounts -- here are the details you need to know. The time has come yet again to update your appeals know-how. CMS announced several changes to the appeals process effective Aug. 3, 2009, in Transmittal 1762. Focus on Higher Dollar Amounts CMS has changed the dollar amount in controversy to file certain levels of appeals. For level-three appeals (administrative law judge hearing), requests filed on or after Jan. 1, 2009, must have at least $120 in controversy. (The old amount was $100.) For level-five appeals (federal court review), requests filed on or after Jan. 1, 2009, must have at least $1,220 in controversy. (The old amount was $1,180.) Other changes were more directed toward Medicare contractors and included the following: • Overpayment cases involving multiple beneficiaries; • Misrouted appeals requests; and • Paid claim appeals template. Get to Know the Appeals Process You should make sure you know the [...]
