Tag archive: documentation

CMS Update – Sharp Rise in Denials for SNF Claims

CMS issued an update regarding what appears to be a sharp increase in the denial rate for Skilled Nursing Facilities (SNFs) as reported in the 2015 Comprehensive Error Rate Testing (CERT) Report. The CERT Report showed denials increasing from 6.9% reported in 2014 to 11% in 2015. What did CMS attribute as the cause of…

CMS Calls for review of “Two-Midnight” Denials

CMS has ordered the Medicare Administrative Contractors (MACs) to re-review all denied claims for admissions under the “two-midnight” rule.  The Final Rule CMS-1599-F has proven to be difficult to implement.  On 2/24/14, CMS issued new guidance, whereby CMS is waiving the timeframe for filing redetermination requests for appeals received before 9/30/14 for claims denied before…

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