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Medicare Fee-for-Service: Opportunities Remain to Improve Appeals Process
Medicare Fee-for-Service: Opportunities Remain to Improve Appeals Process

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By Kathleen M. King (au)
Year: 2016
Pages: 88
Binding Paperback
ISBN 978-1-4578-6448-3

Product Code: 1457864487

In FY 2014, Medicare processed 1.2 billion fee-for-service (FFS) claims submitted by providers on behalf of beneficiaries. When medicare denies or reduces payment for a claim or a portion of a claim, providers, beneficiaries, and others may appeal these decisions through Medicareäó»s appeals process. In recent years there have been increases in the number of filed and backlogged appeals. This report examines (1) trends in appeals for fiscal years 2010 through 2014; (2) data the Department of Health and Human Services (HHS) uses to monitor the appeals process; and (3) HHS efforts to reduce the number of appeals filed and backlogged. Includes recommendations. Tables and figures. This is a print on demand report.

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