tci Medicare Compliance & Reimbursement - 2018 Issue 5

Reimbursement: Do You Qualify for the Low-Volume Appeals Option? Find Out

Settlements will only include a 62 percent partial recoupment. The Medicare claims appeals process can be a major headache. However, thanks to a new CMS program, providers with fewer than 500 Medicare appeals pending can fast track through the sometimes cumbersome and complicated ordeal. Review: This past fall, CMS announced a new accelerated option for appellants with fewer than 500 Medicare Part A or Part B claim appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council at the Departmental Appeals Board (known informally as the Council), combined, as of Nov. 3, 2017...

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