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Tag: Audits

Home / Audits
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Reimbursement

Using the New Request for Hearing Form for Medicare Appeals

The advent of revised regulations for administrative law judge (ALJ) hearings of Medicare appeals includes a new request for ALJ hearing or review of dismissal form. Because the new form …

medical billing audit checklist
Reimbursement

OMHA Announces ALJ Appeal Status Website

This week, the Office of Medicare Hearings and Appeals (OMHA) announced the launch of a new website which will allow providers to check the status of their ALJ appeals. The …

Reimbursement

CMS must provide better oversight to prevent duplicate audits says GAO study

A newly released study by the federal General Accounting Office (GAO) found that the Centers for Medicare and Medicaid Services (CMS) needs to provide better oversight and guidance for provider …

Reimbursement

CMS announces Medicare appeals without ALJ

Medicare Part B Providers will be able to appeal certain Medicare claims decisions without utilizing an administrative law judge, the Centers for Medicare & Medicaid Services announced Thursday. Settlement Conference …

Industry

HME News: AAH moves past anecdotes in audit fight

It’s no secret that audits are out of control, but without data it’s hard to build a case. That’s the problem AAHomecare hopes to help the industry fix with its …

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Regulations

HME News: Bid, audit bills near prime time

Industry stakeholders expect Reps. Pat Tiberi, R-Ohio, and John Larson, D-Conn., to lead a group of lawmakers in introducing a bill this week that would require HME providers to obtain …

Regulations / Reimbursement

Medicare audits hurt providers, lawmakers complain

Efforts to fight fraud in the nation’s massive health care program for seniors have burdened many honest providers, pushing some out of business, lawmakers complained Tuesday. At a House subcommittee …

Government / Reimbursement

Medicare RACs at a crossroads

CMS wants to focus on improper payment prevention, but will providers see fewer burdens? With Medicare’s “two midnight rule” set to take effect later this year and audit appeals facing …

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