tci Part B Insider - 2016 Issue 13

Face-To-Face: MACs Deny Staggering 92 Percent of Claims Under F2F Audits

One MAC maintains nearly a 100 percent denial rate. The face-to-face physician encounter rules that took effect last year are plaguing both physicians and home health agencies, and a recent audit reveals that most practitioners aren’t up to speed with the requirements just yet. The proof: In the Probe & Educate medical review initiative Medicare launched at the end of last year, two Medicare Administrative Contractors have denied more than 90 percent of claims reviewed so far. National Government Services recently said it has denied 300 of 309 claims reviewed under the probe and educate (P&E)...

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