chevron-down Created with Sketch Beta.
0

    What Are... Medicare Appeals? Second Edition

    By Jessica Lee Gustafson and Abby Pendleton

    What Are... Medicare Appeals? Second Edition

    What Are... Medicare Appeals? Second Edition

    By Jessica Lee Gustafson and Abby Pendleton

    A complete overview of the Medicare FFS audit and Medicare appeals environment.

    What Are... Medicare Appeals? Second Edition

    By Jessica Lee Gustafson and Abby Pendleton

    What Are... Medicare Appeals? Second Edition

    What Are... Medicare Appeals? Second Edition

    By Jessica Lee Gustafson and Abby Pendleton

    A complete overview of the Medicare FFS audit and Medicare appeals environment.

    E-books are available in different digital formats; all require e-reader software. After you purchase an e-book, you will download the file to your device and use the software of your choice to access the file. For details, visit the Product Downloads help page.
    $00
    NON-MEMBERS
    $00
    MEMBERS
    $00
    SECTION MEMBERS
    $00
    YOUR PRICE
    $00
    NON-MEMBERS
    $00
    MEMBERS
    $00
    SECTION MEMBERS
    $00
    YOUR PRICE
    *Additional discounts may apply at checkout

    Log In to view your rate

    Unlock the discounted member rate

    Join first as a member, and then purchase this product at special member pricing

    Join Now

    With more than 60 million beneficiaries, the Centers for Medicare & Medicaid Services (CMS) processes more than 1 billion Medicare Part A and Part B Fee-for-Service (FFS) claims each year. The vast majority of these claims are processed without undergoing claims review, creating vulnerability for the Medicare Trust Funds. Authorized by various legislative actions, CMS has contracted with claims review entities to perform post-payment and pre-payment claims review. Health care providers and suppliers that have received a Medicare FFS claim denial or overpayment determination may appeal the initial determination through a five-stage uniform Part A and Part B appeals process.

    This book provides an overview of the Medicare FFS audit and Medicare appeals environment. It starts with an overview of the various CMS contractors performing claims review (including post-payment and pre-payment auditing activities). Then the Medicare Part A and Part B appeals process is examined. Finally, appeal strategies are set forth along with legal challenges applicable to Part A and Part B unfavorable claims determinations, with which attorneys should familiarize themselves when representing a health care entity subject to audit. A list of resources and references is included at the conclusion of this book.

    Product Details

    Publishers

    ABA Book Publishing

    ISBN

    9781641059077

    Page Count

    92

    Product Code

    5630156

    Trim Size

    6x9 Paperback

    Publication Date

    5/12/2021 12:00:00 AM

    Publishers

    ABA Book Publishing

    ISBN

    9781641059084

    Page Count

    92

    Product Code

    5630156EBK

    Trim Size

    E-Book

    Publication Date

    5/12/2021 12:00:00 AM

    Related On-Demand CLE

    Related Events