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Denials by Medicare are on the rise. Congress and the Office of Inspector General have both called for increased scrutiny over Part A and B Medicare claims. Reduced payments to Medicare Advantage Plans have caused the plans to take a more hardline approach to claims approvals and denials. Providers’ main tool to combat these denials is the appeals process. This article will give an overview of the Part A and Part B appeals process as well as the Part C appeals process for Medicare Advantage Plans.
Medicare Advatage Appeals