tci Part B Insider - 2005 Issue 22

Reimbursement: Name-Matching Requirement Could Shave 30% Off Payments

And Ban on Resubmissions of Denied Claims Causes Headaches Physicians are facing denial rates as high as 50 percent due to the new Medicare requirement to match patients' names and other identifiers to their Medicare cards, providers claimed in Medicare's June 7 Physician Open Door Forum. In some cases, providers may have the patient's correct name, but the patient is enrolled in Medicare without a middle initial. Some online databases may provide incorrect information, stymieing providers who haven't had access to a patient's Medicare card directly. Some patients may have registered with Medicare under a nickname, such as "Bobby...

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