The subject keeps coming up, so I decided to create a bill type list and post it for easy reference. This is NOT INTENDED to be a comprehensive explanation of all the bill types. That is beyond the scope of … Continue reading →
“Scope Creep” in Appeals is Dead CMS has instructed MACs and QICs to limit their review to the reason(s) the claim or line item at issue was initially denied. For redeterminations and reconsiderations of claims denied following a complex prepayment review, a complex post-payment review, or an automated post-payment review by a contractor, Limiting the scope of review on redeterminations and reconsiderations of certain claims. MLN Matters Number SE1521.