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Health Exchange Market Place, Medicare Inpatient Claim Appeals, Site Updates

CMS may end Health Insurance Market Place coverage for thousands due to data inconsistencies.

CMS sent an interesting press release a few weeks ago regarding a letter they sent to 300,000 health exchange members. These members need to provide additional information or clarify information from their original application. If they don’t respond, coverage for these members will end on 9/30/2014.

http://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2014-Press-releases-items/2014-08-12.html

CMS Offering Payment on Inpatient Claims Pending Appeal

CMS is actively updating this article they posted regarding the measures they’re taking to reduce the number of appeals they have pending for inpatient stays. As I’m writing this, there’s a teleconference to explain the process. Evidently acute care facilities are eligible for a reduced payment of their charges if they withdraw their appeal.

Site Updates

I just added the most recent Medicare Advantage payer lists and I’ve added links to them in the side bar. Please let me know if you have any trouble downloading them.

 

Sep 9, 2014Payer Goddess
Community Health Systems Massive Data BreachCoventryCare Medicaid PA Migration, CMS HETS Eligibility Change

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