tci Part B Insider - 2021 Issue Q4

Physician Notes: Avoid Medicare Appeals Mix-Ups With MAC Advice

Tip: Ensure you’re sending appeals to the right place. If your appeals seem to be stuck in traffic, you may be sending them in the wrong direction, suggests one Medicare Administrative Contractor (MAC). In a recent alert, Part B MAC WPS-GHA suggests that some providers are causing their own appeals’ delays or dismissals by confusing their level of appeals and sending documentation to the wrong location. “Before sending your appeals request, verify which contractor completes the level of appeal,” WPS-GHA advises. “Is it the Medicare Administrative Contractor (MAC) or Qualified Independent Contractor (QIC)?” Providers...

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