Strategies for appeals of PRO payment denials.
Review of care furnished to Medicare patients by peer review organizations often results in denials of payment for services found not to be "covered" by the Medicare program. Providers should be aware that they can appeal these denials of payment, and that, at least at present, there is a good chance that such denials can be reversed on appeal.
Manning
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Miller
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D005377:Financial Management, Hospital / Q000379:methods*; D007349:Insurance, Health, Reimbursement / Q000331:legislation & jurisprudence*; D006278:Medicare / Q000331:legislation & jurisprudence*; D011366:Professional Review Organizations / Q000331:legislation & jurisprudence*; D014481:United States