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Posting Date: 06/20/2019
Notification Letters
Notification Letters Prior to the start of the TPE, providers are being placed on medical review will receive a notification letter. The notification will have the edit name, the reason for review, instructions for sending in the ADR and [...]
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Posting Date: 01/26/2021
Recovery Audit_Part A-B-FQHC-HHH
What is the Recovery Audit Program? What Is the Recovery Audit Program? The mission of the Recovery Audit Program is to detect and correct past improper payments made on health care claims for services provided to Medicare beneficiaries. The [...]
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Posting Date: 02/02/2021
Who May File an Appeal?
Who May File an Appeal?Any of the following persons or entities is considered a party to an appeal of a claim for items or services payable under Medicare and, therefore, may appeal the initial claim determination and any subsequent appeal [...]
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Posting Date: 02/02/2021
What Documents are Needed
What Documents are NeededYou are required to submit all necessary medical documentation to support the services billed on your claim as part of your participation agreement; you must submit a complete medical record when requesting an appeal. [...]
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