As addressed in the first installment of this three-part series, healthcare providers face potential audits from an increasing number of Medicare and Medicaid contractors. Failing to.
The Medicare appeals process starts well before the first level listed above when a provider receives a medical records request, also known as an additional records request. These requests can come from different Medicare contractors, for example, a MAC or a UPIC.
Every Medicare provider should understand the Medicare administrative appeals process. Providers are entitled to be reimbursed for their services and want to keep those reimbursements.