LLStearns
Guest
Does anyone know the success rate of TPE Appeals? So far, it's not going well. Our Medical Director narratives were done but didn't attach. Has anyone had success appealing? Is it worth getting an attorney?
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Wiki TPE ADR Appeals
- Thread starter LLStearns
- Start date
CBLENNIE
True Blue
I'm guessing based on your location being listed as Ohio that your MAC is CGS and assuming your TPE is for part B claims here what I found on the CGS Top Provider Questions - Parted Probe and Educate page it appears you may be able to be appeal any of your claims that were denied due to medical documentation not being received timely you can request a reopening see question #12 on this page. This is limited to denials with message codes CO50 & M127.
LLStearns
Guest
Actually its hospice part A with palmetto. Should have included that