Medicare Coverage Decisions and Beneficiary Appeals

Medicare Coverage Decisions and Beneficiary Appeals
Author: United States. Congress. House. Committee on Ways and Means. Subcommittee on Health
Publisher:
Total Pages: 194
Release: 2000
Genre: Law
ISBN:

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Guide to Medicare Coverage Decision-making and Appeals

Guide to Medicare Coverage Decision-making and Appeals
Author: Eleanor D. Kinney
Publisher:
Total Pages: 250
Release: 2002
Genre: Business & Economics
ISBN:

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Effective negotiation is essential to the success of any law practice. To help you sharpen your negotiating skills for the challenges you face every day in your professional life, The Lawyer's Guide to Negotiation is a book for lawyers written by lawyers that is uniquely designed to make winning at the negotiating table the norm rather than a hit-or-miss proposition. By following the practical, no-nonsense principles and tactics outlined in this easy-to-read, common-sense guide, you ll find out how to consistently get what you want out of any negotiating session.

A Practical Guide to Medicare Appeals

A Practical Guide to Medicare Appeals
Author: Kathleen Scully-Hayes
Publisher: American Bar Association
Total Pages: 436
Release: 2007
Genre: Law
ISBN: 9781590318270

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A Practical Guide to Medicare Appeals describes the steps necessary to successfully resolve appeals of all types of Medicare determinations. Co-authored by a CMS hearing officer and a private practitioner with years of Medicare appeals experience, this book will walk practitioners through every step of the very confusing and sometimes self-contradictory rules so that appeals can be decided on their merits rather than barred for procedural rules violations.

The Medicare Handbook

The Medicare Handbook
Author:
Publisher:
Total Pages: 12
Release: 1992
Genre: Health insurance
ISBN:

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Improving the Medicare Market

Improving the Medicare Market
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 384
Release: 1996-11-01
Genre: Medical
ISBN: 0309175364

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Medicare beneficiaries are rapidly moving into managed care, as attempts to restrain the growth of this costly entitlement program progress. However, advocates for patients question whether the necessary information and structures are in place to enable Medicare consumers to select wisely among private-sector managed care options. Improving the Medicare Market examines how to give Medicare beneficiaries the same choice of health plan options enjoyed in the private sectorâ€"yet protect them as consumers and patients. This book recommends approaches to ensuring accountability and informed purchasing for Medicare beneficiaries in an environment of broader choice and managed careâ€"how the government should evaluate and approve plans, what role the traditional Medicare program should play, how to help to elderly understand their options, and many other practical matters. The committee discusses the information requirements of Medicare beneficiaries and explores in detail how best to respond to their special needs. And it examines the procedures that should be developed to provide the necessary protections for the elderly in a managed care system.

Medicare Program - Changes to Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)

Medicare Program - Changes to Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage (Us Centers for Medicare and Medicaid Services Regulation) (Cms) (2018 Edition)
Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
Total Pages: 342
Release: 2018-06-16
Genre:
ISBN: 9781721536474

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Medicare Program - Changes to Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicare Program - Changes to Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule revises the procedures that the Department of Health and Human Services (HHS) follows at the Administrative Law Judge (ALJ) level for appeals of payment and coverage determinations for items and services furnished to Medicare beneficiaries, enrollees in Medicare Advantage (MA) and other Medicare competitive health plans, and enrollees in Medicare prescription drug plans, as well as appeals of Medicare beneficiary enrollment and entitlement determinations, and certain Medicare premium appeals. In addition, this final rule revises procedures that the Department of Health and Human Services follows at the Centers for Medicare & Medicaid Services (CMS) and the Medicare Appeals Council (Council) levels of appeal for certain matters affecting the ALJ level. This book contains: - The complete text of the Medicare Program - Changes to Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section

How to Win Medicare Appeals

How to Win Medicare Appeals
Author: David D. Mullens
Publisher:
Total Pages: 280
Release: 2020
Genre: Administrative procedure
ISBN: 9781641055987

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"This book is about how to successfully fight for the payment of medically reasonable and necessary services when Medicare erroneously denies payment, or when Medicare erroneously demands a repayment of overpayment"--