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October 5, 2023 On Thursday, October 5, 2023, CMS announced that the last day the National Supplier Clearinghouse (NSC) will accept provider enrollment appeals and rebuttals is Friday, October 6, 2023.
Beginning Monday, October 9, 2023, all provider... Noridian Healthcare Solutions, the Supplemental Medical Review Contractor (SMRC), has added two new DMEPOS items to their current projects lists: surgical dressings and ostomy supplies.
Noridian will be conducting post-payment review of claims... December 15, 2021 The Office of Medicare Hearings and Appeals (OMHA) announced today that appellants can now file Level 3 Medicare appeals online.
As of December 15, 2021, the OMHA e-Appeal Portal (Portal) is now available, allowing you to:
Securely... September 20, 2021 By Sandra Gauron, Appeals Coordinator
The Centers for Medicare & Medicaid Services (CMS) has provided an alternative dispute resolution to filing an appeal to an Administrative Law Judge (ALJ) in order to prevent backlog since July 2014. The Settlement... In letters mailed to suppliers and providers last week, Performant RAC provided notification that, per CMS authorization, certain medical review activities would again resume. Additionally, the notification provides an additional 30 days to submit discussion... August 12, 2020 By Sandra Gauron, Audit and Appeals Coordinator
In an effort to provide Administrative Law Judge (ALJ) backlog relief, CMS launched the Settlement Conference Facilitation (SCF) pilot program in July 2014. SCF is an alternative dispute resolution... January 23, 2020 By Kim Turner, RN
No matter how careful, Medicare claim mistakes
will happen. When they do, your claim may not be able to be processed by the
DME MAC. Listed below are some common errors which prevent your claim from
being processed. If you find a... October 28, 2019 By Donna Youngblood RN, BSN, CPC
Same or similar denials occur when claims information is
checked against the patient’s CMN history. This will indicate when equipment is
“same or similar” to that piece of equipment being billed on the claim.... In a status report published late last month, the Office of Medicare Hearings and Appeals (OMHA) revealed a reduction in the appeals backlog by 25%.
The OMHA has been actively working to reduce the appeals backlog, from a record high of 886,418 appeals... Effective September 1, 2019, MAXIMUS Federal will serve as the DME QIC for the entire United States and the U.S. territories. This means that any requests for reconsiderations received on or after September 1, 2019 will be processed by MAXIMUS.
With...