1D: (Accretive) Rebilling Part B: What to Do Now
Speaker: Steven J. Meyerson, M.D, Vice President Regulation & Education Group, AccretivePAS®
Abstract:
Medicare has finally responded to the many ALJ and Appeals Council decisions ordering payment under Part B for Part A claims denied because there was a lack of medical necessity for inpatient admission. While hospitals are happy that they will be allowed to bill under Part B for all services provided during the denied inpatient stay (including procedures and surgery) some of the rules will make it difficult or impossible to take advantage of this new opportunity. For example, the interim rule allows rebilling of withdrawn appeals but not self-denial and the proposed rule allows self-denial but imposes timely filing limits. Hospitals need to understand the rules of the game to know when to hold ‘em and when to fold ‘em.
Review the interim rebilling rule and the proposed rule: similarities and critical differences
Learn the mechanism for withdrawing appeals at various levels of the appeal process
Understand when to withdraw an appeal and when to pursue it
Learn the mechanism for withdrawing appeals at various levels of the appeal process
Understand when to withdraw an appeal and when to pursue it
