Medicare Appeals Process Brochure Revised
INDUSTRY NEWS TAGS: CMS
CMS has revised "The Medicare Appeals Process: Five Levels to Protect Providers, Physicians and other Suppliers" brochure for 2011. This brochure provides an overview of the Medicare Part A and Part B administrative appeals process available to providers, physicians, and other suppliers who provide services and supplies to Medicare beneficiaries.
Changes for 2011 include the following:
• When requesting a redetermination, contractors can no longer correct minor errors and omissions on claims through the appeals process.
• The amount in controversy threshold for a third-level appeal administrative law judge hearing is $130.
• The amount in controversy threshold for a fifth-level appeal judicial review in U.S. district court is $1,300.