Tag: Medicare Appeals Process

Medicare appeals process

New CMS Rule: Medicare Appeals Process for Reclassified Patients

On October 11th, the Centers for Medicare & Medicaid Services (CMS) issued a final rule establishing a new Medicare appeals process for Medicare beneficiaries who are initially admitted to a hospital as inpatients but later reclassified as outpatients receiving observation services. This rule is a result of the class-action lawsuit that sought to establish appeal […]
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independent-medical-practices

Maximizing Medicare Reimbursement: Strategies for Independent Practices

In the wake of the COVID-19 pandemic, independent medical practices face many challenges, from adapting to new healthcare methods to major regulatory changes. The main focus of this study is to increase Medicare spending. With the right strategies, independent medical practices can achieve financial sustainability while continuing to provide quality care to their patients. This […]
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The-Evolution-&-Challenges-of-Recovery-Audit-Contractor-Audits

Evolution of Recovery Audit Contractor (RAC) Audits: Challenges, Changes, and Current Landscape

The inception of Recovery Audit Contractor (RAC) audits dates back to 2005, reaching their zenith around 2010 before encountering a deceleration amidst the COVID-19 period. In 2006, Congress granted the Centers for Medicare & Medicaid Services (CMS) the authority to launch the Recovery Audit Contractor program across three initial states: New York, Florida, and California. […]
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