9780735564817
Medicare claims appeals process handbook.
Perling, Lester J.
Aspen Publishers, Inc.
2008
--- pages
$249.00
Loose-leaf Pages in a Ring Binder
KF3608
Essential for anyone who needs to navigate the complexities of
Medicare's five-level appeals process, this volume also addresses
related processes, most notably, the role of national and local coverage
determinations, which are described at length and supplemented by
numerous appendices containing sample cases. Initial chapters describe
in clear language the claims processing system and the new claims
appeals process instituted in 2005. Other chapters address post-payment
audits, initial and re-determinations, reconsiderations of qualified
independent contractors, judicial review, and quality improvement
organization reviews, among other topics. A glossary is provided. The
material is published in loose-leaf format in a 3-ring binder.
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