The proposed changes revise the current policy on Part B billing following the denial of a Part A inpatient hospital claim that a Medicare review contractor has deemed to be not reasonable or necessary.
This is the first year that the Centers for Medicare & Medicaid Services asked representatives from critical access hospitals to help make recommendations on supervision requirements for certain services such as IV hydration and venipuncture via vein.
Under diagnosis-related group 312, providers in Ohio and Kentucky could potentially have their records requested by Medicare recovery audit contractors for a complex medical review. The CIGNA Government Services error rate for DRG 312 is 80 percent.
Prepayment reviews on types of claims associated with high rates of improper payments will begin this month in seven states known to have high populations of fraud- and error-prone providers, says the Centers for Medicare & Medicaid Services.
With temperature records being broken by the hundreds, there's no question that summer is in full swing. So where is the launch of the Centers for Medicare & Medicaid Services Recovery Auditor prepayment review demonstration?
The Centers for Medicare & Medicaid Services has updated its Recovery Auditor program payment figures by quarter and the top audit issues per region. A second update provides appeals statistics for fiscal year 2011.