In Audit
Jun 1st, 2018
If you just got one in the mail, don’t panic. Here’s why you probably received it, and how you should respond to it. The Comprehensive Error Rate Testing (CERT) program, which calculates the Medicare fee-for-service (FFS) program improper payment rate based on stratified random samples of Medicare FFS claims, continuously finds the same five leading causes ...
In Billing
Mar 11th, 2011
A claims processing issue has resulted in claims for HCPCS Level II code J9395 Fulvestrant, 25 mg with dates of service on or after Jan. 1 to be improperly paid by at least one Medicare administrative contractor (MAC). The Centers for Medicare & Medicaid Services (CMS) recently discovered that providers were being underpaid for these ...