Industry Notes: Feds Continue to Scrutinize MA Plans
Medicare Advantage plans have been the subject of both policy updates and scrutiny over the last year — and two recent reports suggest that the feds aren’t letting up on that fixation any time soon.
Report #1: Medicare doesn’t require MA plans to use a claim denial indicator on denied claims, and that makes it a challenge to track such denials. So concludes an HHS Office of Inspector General (OIG) report released on March 2.
“Adjustment codes are not a definitive method for identifying denied claims in the MA encounter data. The descriptions for some adjustment...
To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.
Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.
Current newsletters added each month
Fully searchable archives - over 4200 articles
ALL years/issues back to 2003 organized by year and issue
Codes mentioned in articles are linked to Code Information pages
Code Information pages link back to related articles
Access to this feature is available in the following products: