tci Part B Insider - 2013 Issue 36

Appeals: Appealing Pays, New OIG Report Determines

When you know you’re right, be sure to file a redetermination. If you get a denial from your MAC or a request for a refund from a RAC auditor, you might think that appealing is futile. But more than half of the redeterminations that MACs processed from Part B providers last year were actually decided in the practice’s favor, making your odds pretty good for a positive outcomes. Out of 2.1 million redeterminations decided in 2012, 51 percent were either fully or partially favorable to the Part B practices who filed them, according to a recent...

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