Important tips of Medicare appeal process

Important Changes to Medicare Appeals Process on Horizon

Over the past few months we’ve been telling you about some changes in the
new Medicare Reform Act that haven’t been getting as much attention as the
prescription drug card. One big change that the Medicare Reform Act requires
is a major overhaul of the Medicare appeals system. If your practice has ever
attempted to appeal a Medicare denial of a claim you think should have been
paid, you know that the current Medicare appeals process is unwieldy and slow.
In fact, it’s so tedious and such a hassle that many practices never bother to
appeal denied claims because they feel that the chance for financial recovery
isn’t worth the time and effort required to mount a successful appeal.
But whether your practice often appeals Medicare denials or never does, you
may want to rethink your position. The changes the Medicare Reform Act
requires are likely to have an impact on the time frame for appeals and on the
likelihood of success. The changes aren’t in place yet, but will become partially
effective later this year—and the new appeals process may be in place within
two years.

We’ll explain how the current appeals process works. Plus, we’ll tell you
about the upcoming changes and show you how the changes will affect medical
practices. And we’ll let you know what you should be doing now to be prepared
when Medicare gets its new appeals process up and running.