Q: What statistics are recommended to include in denial summary reports?
Q: What's the process for a fourth level Medicare appeal?
Community Hospital in Munster, Indiana, is disputing an Office of Inspector General (OIG) report that found DRG assignment errors and incorrect inpatient rehabilitation facility (IRF) claims, resulting in an projected $22,051,602 in overpayments.
Q: Can we correct and resubmit a claim denied before payment as we do claims that are sent back with a pre-payment rejection?
Q: How do we determine financial responsibility for denied managed care services?
Q: What type of claims edit data should we capturing and reviewing as part of denials management?