RAD suppliers no longer have to prepare reopening requests to counter a claim processing error in Jurisdictions B and C. According to a recent announcement, CGS will query affected claims and reprocess them without supplier involvement.
[Psst. Andrea and Liz Beaulieu of HME News are discussing Competitive Bid 2021. You can eavesdrop on Wednesday, April 10, 2019, at 1:00 PM (ET).]
Between December 11, 2018 and January 9, 2019, RAD claims incorrectly denied for medical necessity due to a claim processing glitch. CGS originally instructed suppliers to query the CO-50 denials and request a reopening.
Suppliers should refrain from taking action while CGS initiates the process. Upon completion of the mass adjustments, CGS will provide further instructions on how to address remaining claims.
SOURCE LINKS
https://cgsmedicare.com/jb/pubs/news/2019/03/cope11694.html
[Psst. Andrea and Liz Beaulieu of HME News are discussing Competitive Bid 2021. You can eavesdrop on Wednesday, April 10, 2019, at 1:00 PM (ET).]
Between December 11, 2018 and January 9, 2019, RAD claims incorrectly denied for medical necessity due to a claim processing glitch. CGS originally instructed suppliers to query the CO-50 denials and request a reopening.
Suppliers should refrain from taking action while CGS initiates the process. Upon completion of the mass adjustments, CGS will provide further instructions on how to address remaining claims.
SOURCE LINKS
https://cgsmedicare.com/jb/pubs/news/2019/03/cope11694.html