tci Medicare Compliance & Reimbursement - 2008 Issue 19

Part B Mythbuster: Device Maker Offering To Appeal For You? Not So Fast

Consider the more conservative approach of the manufacturer guiding your appeal Myth: Your best chance of overturning a denied claim lies in the device manufacturer's appeal on your behalf.Reality: The most effective way to stay on top of your appeal is to shepherd it through the process on your own. The device manufacturer might help guide you, but the ball should stay in your court.Example: Your Medicare carrier denies a claim for cervical disc replacement. The disc manufacturer offers to take over the appeal for you. Although the manufacturer has an interest in getting the denied portion...

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