tci Part B Insider - 2011 Issue 22

Medicare Errors: No Physician Order for These Services, No Part B Payment

One MAC shows exactly which errors it found during a recent review.If your physician is simply too busy to sign orders for lab or radiology reports, he won't be busy counting his Medicare reimbursement, because MACs aren't required to pay you for services that are missing documentation.A recent CERT report from Highmark Medicare Services, a Part B payer in five states, shows that the majority of errors that the MAC found in the "insufficient documentation" category were related to the lack of a valid physician's signature in the documentation, or that a radiology report/diagnostic test performed had...

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