LTC Matters: Maximizing Medicare Reimbursement Through Effective Claims Management
1/1/2003
All Medicare-certified providers have been adversely impacted by Congress?s failure to restore the Prospective Payment System (PPS) add-ons that expired on October 1, 2002. While a renewed lobbying effort is underway to raise these issues more successfully in the 108th Congress, providers should be aware of another, more insidious reimbursement reduction, that is negatively affecting cash flow and revenues. As a result of postpayment review efforts by the fiscal intermediaries, many providers are encountering denials, partial denials, and downcoding of reimbursement claims. Unless aggressive steps are taken to stem this form of reimbursement reduction, drastic cutbacks in Medicare revenues will result. The purpose of this article is to encourage and assist providers in establishing and maintaining a program to ensure resolution of appeals at the lowest possible level.
