tci Part B Insider - 2022 Issue Q1

Medicare Appeals: Boost Appeals Success With 3 Expert Tips

Hint: Understand the ‘why’ of the appeal. When you’re a Medicare Part B provider, you’re allowed to appeal claims decisions you disagree with. However, if you lose more appeals than you win, you may be missing some key steps. Follow these expert tips to improve your chances of avoiding — or winning — appeals. Tip 1: Check Twice, Submit Once Before you file a Medicare claim, you should double check a few details that could lead to a denial. Coverage: All Medicare claims rely on documentation that the procedure is medically necessary, as evidenced by the...

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