Original Medicare, Medicare Advantage, and Part D plans can deny coverage for a health service or medication. However, individuals have a legal right to appeal the decision if they think it is ...

On October 11, 2024, CMS issued a final rule establishing a new appeals process for Medicare beneficiaries who were initially admitted to a hospital as an inpatient but are later reclassified as an ...

A final rule announced by the Centers for Medicare & Medicaid Services Thursday revised the appeals process for Medicare Advantage beneficiaries who have been denied coverage. The new rule should be a ...

Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, ...

Medicare beneficiaries often face the frustrating experience of having their claims denied. However, understanding the ...

If you disagree with a Medicare penalty, surcharge, or decision not to cover your care, you have the right to appeal. There are multiple levels of available appeals for all parts of Medicare. You can ...

Health insurance companies don’t always pay for items the first time coverage is requested, and they don’t cover everything they’re asked to. You, the consumer, may need to file an appeal to get the ...

A: The Medicare Appeals process will remain the same for physicians under Part B and Part A non-inpatient claims. The only difference under Part A is for the inpatient hospital claims under the ...

CMS has revised its brochure, “The Medicare Appeals Process: Five Levels to Protect Providers, Physicians and Other Suppliers,” according to an AAPC release. The brochure provides information on the ...

HHS should take more steps to improve its oversight of the Medicare fee-for-service appeals process and to reduce the increased volume of appeals, the Government Accountability Office said in a report ...

Maximus Inc. will provide outsourcing services for the Centers for Medicare and Medicaid Studies to facilitate its appeals process under a three-year contract that could be worth as much as $13.1 ...