“Finally Friday!” Strategies for Medicare Level 3 Appeals

FRIDAY October 17, 2014

Medicare Appeals at Level 3:
Providers Left in the Lurch

Veteran Appeals Attorneys
Review Recent Experiences with ALJs

How Can You Prepare & Respond?

Watch the Replay and Get the Handouts

What to expect from the ALJ Level, now and in the near future.

What to expect from the ALJ Level, now and in the near future. Listen to advice from Jessica and Abby, who argue for providers before ALJs on a constant basis.

Since CMS began re-educating the Judges at the Office of Medicare Hearings and Appeals (OMHA) earlier this year, there have been far fewer Favorable decisions coming of hearings held at Level 3 of the Medicare appeals process. Have you experienced this? Whether you have as yet or not, you are facing a new attitude in many of the Administrative Law Judges (ALJs), of late, and it may get worse before it gets before.

Jessica and Abby presented a full 1-hour review of recommended appeal strategies at the PAUR Boot Camp, this past July in Chicago. Click the image to see a video preview of that session.

Jessica and Abby presented a full 1-hour review of recommended appeal strategies at the PAUR Boot Camp, this past July in Chicago. Click the image to see a video preview of that session.

That’s our collective estimate, considering the facts at hand – lower overturn rates – and possible attitude changes we can envision for those providers who do not accept the CMS Global Settlement Offer.

So, we asked Jessica Gustafson and Abby Pendleton from The Health Law Partners to give you a review of their recent experiences with ALJs, including some viewpoints and advice on how best to prepare.

Hear them reveal what they are *now* seeing MACs and RACs argue, for claims filed before and after the Two-Midnight Rule went into effect.

DRAFT VERSION of our latest Decision Tree on determining if a claim is eligible for settlement. Watch for PDF version on Friday AM.

Also, you’ll get my new Decision Tree – designed to help you “see” if a claim may be considered “eligible” for submission to the CMS Global Settlement offer.

 

Handouts

…included in this week’s Handouts…

Finally Friday! Show Slides
Health Law Partners PPT Slides
Health Law Partners ALJ Delays article with 77 references
CMS FAQs updated 10/14/2014
Eligible for Settlement Decision Tree v1
Settlement Offer Overall Process Tree v2
Settlement Offer Validation Process Tree v1

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QUICK REPLAY - This Week's Show

This link to a raw, unedited recording is offered here until we can edit a final version for archiving. Hope you enjoy the show! Please note: this will open a player in your browser, in this same page. Use your browser’s “Back” button to stop the video and return to this page.

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We Appreciate Our Sponsors for this show:

 Craneware  |  The Health Law Partners

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