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The CERT study gives one the opportunity to identify potential errors the same way that the auditors do. With nearly a million physicians in this country, how do auditing organizations determine who to audit? As of 2011, a total of 100 percent of Medicare fee-for-service claims started being passed through…
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CERT claim review highlights need for strategic approach. How do you handle your appeals when there is more than one issue being denied? For example, if the payer denies both the medical necessity of the level of care as well as the coding of a procedure, what strategies should you…