tci Medicare Compliance & Reimbursement - 2005 Issue 41

PHYSICIANS: Feds Moving Toward Reduced Medical Review Period

Want off medical review?  Do not argue with auditors.Carriers can still drive physicians nuts with documentation requests and prepayment reviews--but soon, at least, there may be a time limit.The Centers for Medicare and Medicaid Services published a proposal to limit the time a carrier can put on a physician's prepayment medical review to one year. And if the physician's error rate decreases by 70 percent, then the carrier has to let the physician off medical review sooner, according to the proposal in the Oct. 7 Federal Register. Here's the catch: If a doctor's error rate is...

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