Industry Note:
MAC Denies 9% Of High-Resource Claims In One Review
Published on Fri Jul 21, 2017
Therapy once again tops the reasons for denials in Palmetto GBA’s latest medical review effort. The HHH Medicare Administrative Contractor recounts denying 9 of 98 1CHP* claims reviewed in New Mexico. 1CHP indicates claims with the highest Clinical, Functional, and Service Domain scores. The review covered claims processed between November 2016 and May 2017. However: “The total dollars reviewed was [...]