Demystifying Level One Appeals Navigating Medicare: Home Health & Hospice Insights for Providers
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- How To
Erin and Christa sit down with Rachel Caron and Jessica Channell from our Appeals department to talk about the difference between a reopening and a redetermination. We also discuss what documentation is required to submit a first level appeal, how best to submit them, and where to find information and guidance on how to process/submit appeals.
Visit our website at www.ngsmedicare.com to find additional information on the types of services you may appeal, as well as a list of medical records that may assist in supporting the services billed are coverable by Medicare. Select HH+H as your line of business, choose your state, then select Resources > Claims and Appeals. The articles on the left-hand side go over submitting appeals via NGSConnex, esMD, and Hard Copy.
To find more information or guidance on how to process/submit appeals go to CMS IOM Publication, Medicare Claims Processing Manual, Chapter 29 – Appeals of Claims Decisions, Section 310.5
If you have a question or topic, (or both!) you would like us to cover in a future podcast, send them our way! You can reach us at NGSHHHPOE@elevancehealth.com.
Erin and Christa sit down with Rachel Caron and Jessica Channell from our Appeals department to talk about the difference between a reopening and a redetermination. We also discuss what documentation is required to submit a first level appeal, how best to submit them, and where to find information and guidance on how to process/submit appeals.
Visit our website at www.ngsmedicare.com to find additional information on the types of services you may appeal, as well as a list of medical records that may assist in supporting the services billed are coverable by Medicare. Select HH+H as your line of business, choose your state, then select Resources > Claims and Appeals. The articles on the left-hand side go over submitting appeals via NGSConnex, esMD, and Hard Copy.
To find more information or guidance on how to process/submit appeals go to CMS IOM Publication, Medicare Claims Processing Manual, Chapter 29 – Appeals of Claims Decisions, Section 310.5
If you have a question or topic, (or both!) you would like us to cover in a future podcast, send them our way! You can reach us at NGSHHHPOE@elevancehealth.com.