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Diane Publishing Books
Medicare Fee-for-Service: Opportunities Remain to Improve Appeals Process
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Kathleen M. King (au)
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 Medicareńˇ╗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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