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Tag: Medicare appeals

On the Editor's Desk

To be continued ...

March 17, 2022Liz Beaulieu, Editor

When we included a Q&A with Josh Britten in our HME Newswire in February, I wasn’t surprised it resonated with readers. Britten, CEO of BritKare Home Medical, shared his battle to get back nearly $650,000 in denied Medicare claims – a battle that took him six years and more than $100,000 in legal and consultant fees. One provider responded to the story on Twitter by writing: “When you incentivize claims denial as a means of revenue generation you will find reasons to deny...

Administrative Law Judge, Josh Britten, Medicare appeals, Wayne van Halem

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HHS asks court to back off

November 9, 2016HME News Staff

WASHINGTON - The Department of Health and Human Services has asked the U.S. District Court for the District of Columbia not to intervene in the Medicare appeals process.In a brief filed Nov. 7, HHS asks for the dismissal of a case brought by the American Hospital Association that seeks a court order requiring HHS to implement procedures that would curtail a massive appeals backlog.HHS recently reopened a settlement program that offers certain hospitals an opportunity to receive nearly two-thirds...

Medicare appeals

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CMS contractor expands phone demo

November 4, 2016Liz Beaulieu, Editor

JACKSONVILLE, Fla. - C2C Innovative Solutions, the contractor handling the second level of the Medicare appeals process, has received the green light from CMS to expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.C2C, CMS's Qualified Independent Contractor or QIC, received word from the agency on Nov. 1 that it can open the demo to all product categories, with the exception of power mobility devices, Daniel...

ALJ, Audits, C2C Innovative Solutions, Medicare appeals

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Bob Soltis: Former ALJ tells all

September 23, 2016Liz Beaulieu, Editor

CLEVELAND - Spoken like a true lawyer, Bob Soltis' advice for HME providers working claims through the Medicare appeals process: be brief and be concise.Soltis, a former administrative law judge and the author of the recently published book “How to Handle Your Medicare Hearing,” spoke to HME News in the wake of the Department of Health and Human Services' proposed changes to the appeals system, an attempt to reduce a massive backlog at the ALJ level.HME News: How can providers be brief...

ALJ Backlog, Bob Soltis, Medicare appeals

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