tci Medicare Compliance & Reimbursement - 2017 Issue 23

Industry Notes: Double-Check Appeals' Requests and Jurisdiction, MAC Urges

CMS paperwork can be confusing, but one Medicare Administrative Contractor is reporting an uptick in problems with appeals processing. "CGS [Medicare] has noticed an influx in receiving misrouted appeal requests from providers," said the MAC in a Nov. 21 notice. "In some cases, providers are using the correct contractor appeal form; however, mailing to the incorrect contractor address." The MAC, which processes Jurisdiction 15 claims, encourages providers to review thoroughly their Medicare Remittance Advice (RA) before sending appeals out. Both the name of the contractor and the correct address on where to forward appeals can be found...

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