Medicare Monthly Review Details

How to Avoid Costly Appeals

National Government Services has noticed an increase in requests for claim appeals. Upon review, we have found that many of the requests are not appropriate and/or necessary for a claim appeal submission.

The appeals process for claims is used when adjudication may be changeable based on additional information which was not available during the initial claim determination.

We’ve published a helpful resource to help providers determine if a request for appeal is appropriate. How to Avoid Costly Appeals includes initial submission tips and resources for common denial codes.

In addition, we invite you to watch NGS Provider Outreach & Education Consultant Carleen Parker speak about NGS’ Holistic Approach to Avoiding Administrative Burden. During this six-minute YouTube video, Carleen shares steps to follow before submitting your claim(s).

Please consider viewing this information before requesting an appeal. Following the steps outlined will help reduce claim denials and improve efficiencies.