Author: Kathleen Scully-Hayes
Publisher: American Bar Association
ISBN: 9781590318270
Category : Law
Languages : en
Pages : 436
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Book Description
A Practical Guide to Medicare Appeals describes the steps necessary to successfully resolve appeals of all types of Medicare determinations. Co-authored by a CMS hearing officer and a private practitioner with years of Medicare appeals experience, this book will walk practitioners through every step of the very confusing and sometimes self-contradictory rules so that appeals can be decided on their merits rather than barred for procedural rules violations.
Author: David D. Mullens
Publisher:
ISBN: 9781641055987
Category : Administrative procedure
Languages : en
Pages : 280
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Book Description
"This book is about how to successfully fight for the payment of medically reasonable and necessary services when Medicare erroneously denies payment, or when Medicare erroneously demands a repayment of overpayment"--
Author: Jessica L. Gustafson
Publisher: American Bar Association
ISBN: 9781627228787
Category : Law
Languages : en
Pages : 61
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Book Description
A complete overview of the Medicare FFS audit and Medicare appeals environment.
Author: United States. General Accounting Office
Publisher:
ISBN:
Category : Medicare
Languages : en
Pages : 54
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Book Description
Author: Bob Soltis
Publisher: Lulu.com
ISBN: 1483434974
Category : Law
Languages : en
Pages : 100
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Book Description
In the last four years, the Chief Judge's office at the Office of Medicare Hearings and Appeals has squandered millions of our tax dollars hiring HQ staff instead of worker bees. It affects all of us, not just those enrolled in Medicare. Hurry Up and Wait relies on the perspective its author gained presiding over more than 3,500 Medicare hearings as an administrative law judge. It gives an overview of Medicare, explains the appeal process, shows how mismanagement at OCALJ and poor work by CMS contractors created a 600,000 case backlog, analyzes proposals to fix the problem, provides real solutions, and shows you how to make your voice heard to make much needed changes in the system. A portion of the proceeds are donated to worthy causes, such as the Center for Medicare Advocacy, and Save Lakewood Hospital. Note: You can buy a book without setting up a Lulu account. Thank you.
Author: U. S. Department Human Services
Publisher: CreateSpace
ISBN: 9781493511273
Category :
Languages : en
Pages : 56
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Book Description
An appeal is the action you take if you disagree with a coverage or payment decision made by Medicare, your Medicare Advantage Plan (like an HMO or PPO), other Medicare health plan, or your Medicare Prescription Drug Plan. You have the right to appeal if Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan denies one of these: A request for a health care service, supply, item, or prescription drug that you think you should be able to get; A request for payment of a health care service, supply, item, or prescription drug you already got; A request to change the amount you must pay for a health care service, supply, item, or prescription drug. You can also appeal if Medicare or your plan stops providing or paying for all or part of a health care service, supply, item, or prescription drug you think you still need. This publication has important information about: How to file an appeal if you have Original Medicare; How to file an appeal if you have a Medicare Advantage Plan or other Medicare health plan; How to file an appeal if you have Medicare prescription drug coverage; Where to get help with your questions. Also available in Spanish.
Author: United States. Congress. Senate. Committee on Finance. Subcommittee on Health
Publisher:
ISBN:
Category : Administrative remedies
Languages : en
Pages : 410
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Book Description
Author:
Publisher: DIANE Publishing
ISBN: 142894236X
Category :
Languages : en
Pages : 51
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Book Description
Author: Jessica L Gustafson
Publisher:
ISBN: 9781641059077
Category :
Languages : en
Pages : 92
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Book Description
A complete overview of the Medicare FFS audit and Medicare appeals environment.
Author: Lester J. Perling
Publisher:
ISBN: 9780735564817
Category : Administrative remedies
Languages : en
Pages : 0
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Book Description
Anyone who submits Medicare claims and receives Medicare reimbursements needsto be fully prepared to follow the appeals process when claims are rejectedand/or refunds are requested.Medicare Claims Appeals Process Handbook helps you understand - and explain -the process every step of the way. You'll know exactly what you can and can'tdo, the essential timeframes for pursuing appeals, where to send information,and how to proceed - at every level of the appeals process!The Medicare Claims Appeals Process Handbook will help you:Increase yourlikelihood of success in the claims appeal by lowering the possibility ofprocedural error and avoiding costly errorsNavigate all four levels of the administrative appeal processProceed to federal court if necessaryStay current with changing rules, regulations, and proceduresPut best practices in place - immediately!Only Medicare Claims Appeals Process Handbook includes letters, forms, charts,and more - all designed to provide you with practical support throughout theprocess.Medicare Claims Appeals Process Handbook has been updated to include:Expanded material on electronic claims submissionA sample denial of an "unusual circumstance" waiver requestInformation on medical necessity denialsA new National Coverage Analysis (NCA) tracking sheet and proposed decisionmemo for MRIsUpdated Medicare redetermination request formsRequest for review of Administration Law Judge (ALJ) Medicaredecision/dismissalComparison of standard and expedited appeals processesUpdated CMS appointment of representative formNew material on the role of the Medicare administrative contractorA sample Medicare Summary NoticeImportant information on overpayment and suspension of paymentsRecent case law regarding exhaustion of administrative remediesUpdated material on good cause for reopening
