If you disagree with a decision made by Medicare, you can appeal. But first, check to see if the culprit is something simple ...

Lots of health care service providers find themselves in the position of needing to file a Medicare appeal. Despite the systematic nature of modern Medicare billing, wrongful denials remain common, ...

A Medicare Advantage plan denied coverage for a walker a physician ordered for a 76-year-old patient at risk of falling. The insurance company reported denying the walker because the patient received ...

Health plans routinely assert that contracted providers must appeal underpayments or claim denials according to the health plans’ internal dispute process. The payer/provider agreement itself, or ...

Medicare Recovery Auditors (RACs) rate of claims denials to hospitals has continued to grow, as the number of denials was up 23 percent in the most recent quarter, according to the American Hospital ...

Multiple Medicare administrative contractors representing 24 states have proposed limiting coverage for some chronic pain procedures and therapies. A proposed policy revision published Sept. 25 ...

The change hits in the new year as traditional Medicare recipients undergo a federal AI pilot program in Washington, Arizona, ...

Recovery audit contractors and Medicare administrative contractors will coordinate activities in their hunt for overpayments to hospitals, according to a report by the Report on Medicare Compliance.

An annual evaluation of Medicare administrative contractors (MACs) found information security gaps increased 16% between 2014 and 2015, including several recurring high-risk concerns. Each of the nine ...