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Politics : A US National Health Care System?
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To: John Carragher who wrote (7528)7/14/2009 12:03:30 PM
From: Lane3  Read Replies (2) of 42652
 
they said they constantly go through numerous filings at times with medicare to get payments

The examples you mention sound like mistakes being made either in the filing or in the review of the claim. If mistakes in filing are made, then claims will be denied until the mistakes are corrected. If mistakes are made by the processor of the claim, well, mistakes happen regardless of the system.

What was in question, or so I thought, was whether Medicare acts arbitrarily on claim approval. Still haven't seen an example where this is the case.

i got copies of this as medicare wants to know if any questionable charges.

Have you seen any initiative from Medicare to prompt the reporting to them of questionable charges. The reason I ask is that I have never seen that either in my own experience with Medicare or in looking after my father in home hospice. I posted earlier about them setting up a hotline for reports of possible fraud. How would you let them know if you spotted questionable charges? Is there some procedure?
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