TITLE

Adjust Your Appeals Sails Before You Invest the Time and Money

PUB. DATE
July 2010
SOURCE
Eli's Rehab Report;Jul2010, Vol. 17 Issue 7, p51
SOURCE TYPE
Periodical
DOC. TYPE
Article
ABSTRACT
The article reports on the new amount-in-controversy requirements to adjust the administrative law judge (ALJ) appeal in the U.S. The Centers for Medicare and Medicaid Services (CMS) has released the Transmittal 1965 which provides requirements for the claim amount in controversy on a level 3 and level 5 appeal. It presents a chart for Medicare Fee-for-Service appeals process with regards to the appeal level, time limit for filing request, and the monetary threshold to be met.
ACCESSION #
52303869

 

Related Articles

  • NUCC recommends April 1, 2014, implementation of new 1500 claim form. Tennant, Robert // MGMA Connexion;Oct2013, Vol. 13 Issue 9, p18 

    The article reports on the recommendation of the National Uniform Claim Committee (NUCC) to implement the Centers for Medicare and Medicaid Services (CMS) 1500 claim form required for claim submissions to Medicare in the U.S. on April 1, 2014. It provides details of the changes to the existing...

  • DATA TRENDS.  // hfm (Healthcare Financial Management);Jan2008, Vol. 62 Issue 1, p120 

    The article cites recent actions and announcements by Centers for Medicare & Medicaid Services (CMS) which have raised concerns among healthcare organization in the U.S. CMS began collecting present-on-admission (POA) information on all inpatient Medicare claims on October 1, 2007. The agency...

  • Providers reminded NPI required beginning Jan. 1.  // Hospital Access Management;Dec2007, Vol. 26 Issue 12, p143 

    The article reports that starting January 1, 2008, hospitals and other health care providers will be required by the U.S. Centers for Medicare & Medicaid Services (CMS) to use a National Provider Identifier when they bill Medicare fiscal intermediaries and Medicare administrative contractors....

  • Part B Claims Remain in Holding Pattern Through June 17.  // Part B Insider;6/12/2010, Vol. 11 Issue 22, p169 

    The article reports that Medicare Administrative Contractors (MAC) would not process June claims until June 18, 2010 according to a notification by the Centers for Medicare and Medicaid Services (CMS). It states that the Part B practices were due to face a 21 percent cut effective from June 1...

  • "RAC" Up for Providers. Murer, Cherilyn G. // Rehab Management: The Interdisciplinary Journal of Rehabilitatio;Apr2009, Vol. 22 Issue 3, p40 

    The article focuses on the recovery audit contractors (RAC) designed by the Centers for Medicare and Medicaid Services (CMS) in the U.S. The program was created to identify and correct the passed improper payments in the Medicare fee for service program and to provide information to CMS and the...

  • NCI Completes Acquisition of AdvanceMed.  // Biomedical Market Newsletter;5/21/2011, p452 

    The article reports on the acquisition of AdvanceMed Corp., provider of healthcare program integrity services, by information technology (IT) provider NCI Inc. in the U.S. The acquisition is worth 62 million dollars, including a state-of-the-art data center to support Zone Program Integrity...

  • Medicare: Recent CMS Reforms Address Carrier Scrutiny of Physicians' Claims for Payment: GAO-02-693.  // GAO Reports;5/28/2002, p1 

    In 1990, GAO designated the Medicare program to be at high-risk for waste, fraud, and abuse. More than a decade later, Medicare remains on GAO's high-risk list. This report examines Medicare's claims review process, which is designed to detect improper billing or payments. GAO found that most...

  • MEDICARE PROGRAM INTEGRITY. King, Kathleen M. // GAO Reports;8/13/2014, preceding pi 

    The article examines a U.S. Government Accountability Office (GAO) report on the postpayment claims of Medicare contractors of the Centers for Medicare & Medicaid Services (CMS) as of July 2013. The report reviews four types of contractors including Medicare Administrative Contractors (MAC),...

  • CMS Publishes First Batch of Billing Edits from Medically Unlikely Edit Program.  // American Family Physician;11/15/2008, Vol. 78 Issue 10, p1138 

    The article reports on the release of the first batch of the billing edits in the Medically Unlikely Edit (MUE) program by the U.S. Centers for Medicare and Medicaid Services (CMS) on October 1, 2008. It notes that the edits are used during the electronic processing of claims to ensure that...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics