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The Massive Medicare Appeals Backlog is Significantly Harming Providers, What You Can Do To Stop It

March 20, 2019Few occurrences in healthcare billing and coding will bring instant anxiety as receiving an overpayment demand from one of CMS’ contractors. We all know that we are lucky if we make it through the first two levels of appeal (Redetermination-Level 1 and Reconsideration-Level 2) with 100% success on all claims, even if every claim was billed correctly. Posted by Bryan Meek, Esq.new

Unprecedented Medicare Reversal Victory for BMD's Health Law Department

February 25, 2019BMD's RAC Team, lead by attorney, Amanda L. Waesch, reversed a $3.6 million over-payment at Level 1. Posted by Client Alert

CLIENT ALERT: Low Volume Appeals Settlement for RAC Appeals

May 4, 2018In April, the Centers for Medicare & Medicaid Services (“CMS”) issued a new settlement proposal to providers with outstanding appeals at the Office of Medicare Hearings and Appeals (“OMHA”) and the Medicare Appeals Council (“MAC”). Essentially, CMS is offering to pay up to 62% of the claim to the provider for qualifying claims that are currently in the appeal process. Interested providers may submit an Expression of Interest (“EOI”) to CMS by June 8, 2018. Providers should explore this settlement opportunity and submit an EOI to receive an offer of settlement. Providers may decline the offer after the EOI is submitted. Brennan, Manna & Diamond, LLC’s Provider Relations, Audit, and Appeals Unit, a division of its Healthcare Department, is able to assist providers with filing the EOI, analyzing the outstanding claims subject to the settlement, and reviewing the Administrative Agreement that is offered by CMS. Posted by BMD Health Law Department