In this episode Sean sits down with Ashley Morgan of Liles Parker to discuss the Administrative Appeals Process within CMS and the recoupments after level II and recent rulings by the 5th Circuit Court of Appeals and other courts. Sean and Ashley provide insights for who's reviewing your claim(s), what the program integrity manual sets as Medical Record (MR) Scope of Work (SOW) for claims reviewers and how to ensure due process.
The episode also focuses on what leads to a provider's...
In this episode Sean sits down with Ashley Morgan of Liles Parker to discuss the Administrative Appeals Process within CMS and the recoupments after level II and recent rulings by the 5th Circuit Court of Appeals and other courts. Sean and Ashley provide insights for who's reviewing your claim(s), what the program integrity manual sets as Medical Record (MR) Scope of Work (SOW) for claims reviewers and how to ensure due process.
The episode also focuses on what leads to a provider's revocation of billing privileges with CMS and the steps that can be taken to reverse the revocation. Revocations are happening at a frenzied pace and before it happens to you, get the facts!
This is such a critical discussion for those who are responsible for filing appeals at a medical practice, hospital, health system, suppliers, or other types of medical organization.
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