tci Medicare Compliance & Reimbursement - 2015 Issue 11

Brace Yourself For Extraordinary OMHA Timeframes

Expect average processing time for appeals decisions to exceed 540 days. Due to the overwhelming receipt levels and already huge backlog of Medicare claims appeals, don’t hold your breath when you’re waiting for the HHS Office of Medicare Hearings and Appeals (OMHA) to hear your appeal.  The average processing time for appeals decisions in fiscal year (FY) 2015 is a whopping 547 days, and OMHA projects a 20- to 24-week delay in entering (“docketing”) new requests into its case processing system. Here are the statistics you need to know when appealing a Medicare claim...

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