This session was recorded on Friday, June 7, 2013. Today’s show is an interview with Jim Tate, aka The EMR Advocate. Jim talks about the new wave of audits coming from a new CMS contractor, reviewing the attestations made by … 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.