decisionhealth Newsletters, Part B News - 2008 Issue 11 (November)
OIG finds early QICs struggled to meet deadlines
Subscribe or sign in to view the full article.
Article Overview
This article summarizes an HHS Office of Inspector General review of early Medicare Part B Qualified Independent Contractor (QIC) operations and the challenges they faced in meeting appeal-processing deadlines. It also notes CMS’s response to those early problems and discusses the general topic of escalation when appeal processing runs late, making the piece relevant to Medicare appeals staff, billing professionals, and compliance teams monitoring Part B reconsideration workflows.
Why This Topic Matters
Timely appeal handling affects Medicare claims resolution, provider rights in the appeals process, and whether cases can move to the next level of review when deadlines are missed.
Article Sections
-
Early QIC performance and OIG findings
Summarizes the OIG review of early Part B QIC activity and the operational issues identified during the first months of 2006.
-
CMS response and operational changes
Describes CMS’s comments on the review and its early steps to address contractor performance and case-handling concerns.
-
Escalation when a QIC misses the deadline
Explains the general appeal-process topic of escalation to the next review level when a reconsideration is not completed on time.
What You Will Learn
- How early Medicare Part B QIC operations were performing after the change from Carrier Fair Hearings
- What kinds of administrative problems were noted in the OIG review
- How CMS responded to early appeal-processing concerns
- What the article says generally about escalation when appeal deadlines are missed
Who Should Read This
- Medicare billing professionals
- Certified coders
- Practice managers
- Revenue cycle staff
- Compliance staff
- Appeals and grievance staff
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com