decisionhealth Newsletters, Part B News - 2021 Issue 10 (October)
First-level appeals drop, but success rate rises for Part B providers, DME
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Article Overview
This article summarizes Medicare Part B appeals trends for providers and suppliers, including durable medical equipment claimants, using CMS fee-for-service appeals data from 2013 through 2020. It is relevant to billing, reimbursement, and compliance professionals who monitor claim denials, appeal activity, and contractor-level outcomes.
Why This Topic Matters
Appeals performance can affect cash flow, denial management, and operational planning for organizations billing Medicare Part B claims. Understanding broad redetermination trends helps stakeholders assess whether appeal volumes, denial rates, and first-level outcomes are changing over time.
What You Will Learn
- How Medicare Part B appeal activity changed over the review period
- How denial rates and appeal volumes trended for providers and suppliers
- How durable medical equipment claimants compared with other Part B claimants
- What the CMS appeals fact sheets show about first-level redeterminations
Who Should Read This
- Medical coders
- Billing specialists
- Revenue cycle staff
- Compliance professionals
- Practice managers
- Durable medical equipment suppliers
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