Medicare Claims Appeals Process--A Refresher
Reprinted with Permission from the Medical Association of the State of Alabama
With the increased audit activity we are seeing among the alphabet soup of Medicare contractors- RACs, ZPICs, SMRCs, CERTs, etc.-now appears to be a good time for a refresher on the Medicare claims appeals process. Due to this increased audit activity, more and more claims are being denied, both under pre-payment review and post-payment review. This article provides an overview on the Medicare claims appeals process, as well as some tips and pointers to keep in mind.