The report shows that of 40,000 appeals in 2010, 56 percent of the time administrative law judges reversed claims denials in favor of appellants. When healthcare professionals filed, their rate of favorable decisions was 61 percent, compared to 28 percent when beneficiaries filed and 22 percent when state Medicaid agencies filed.
The OIG has recommended better training on Medicare policies to administrative law judges and clarification on unclear policies.
More Articles on Orthopedic Surgeons:
5 Tips for Entrepreneurial Spine Surgeons to Stay Independent
Cleveland Clinic surgeons Perform Knee Surgery on Indians Pitcher Corey Kluber
20 Statistics on Orthopedist Compensation vs. Other Specialists
Report: Courts Favor Physicians in Coverage Denial Appeals FeaturedWritten by Laura Miller | Tuesday, 04 December 2012 09:00
A new report from the Office of the Inspector General shows that physicians fighting coverage denials have a good chance of succeeding, according to an American Medical News report.
© Copyright ASC COMMUNICATIONS 2011. Interested in LINKING to or REPRINTING this content? View our policies here.
New from Becker's Orthopedic & Spine Review