Description
The Centers for Medicare & Medicaid (CMS) Quality Improvement Organization (QIO) reviews thousands of appeals annually. In 2019, approximately 50% of Florida appeals submitted were terminated due to technical failures which were often the fault of the submitting provider. These failures can result in substantial revenue loss to the provider. Multi-faceted, these failures include issues with the Notice of Medicare Non-Coverage (NOMNC) form, records submission, and meeting deadlines. During this program, the speaker will review the basics of NOMNCs, how to respond to a QIO appeal request, and how to avoid common mistakes.
Course Author: Nanette Smith NHA
Objectives
By the conclusion of this program, the attendee should be able to:
- Understand the background and federal requirements for issuing a NOMNC, and the beneficiary's right to appeal to the QIO.
- Explain how to properly issue a NOMNC, respond to a QIO appeal, and the critical importance of understanding the process.
- Recognize the most common errors associated with NOMNCs and appeals that can have a financial impact on the provider.
Certificate
By completing/passing this course, you will attain the certificate HCAF Course Certificate
Learning credits
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