NHIC said the results of a review for claims paid in Q3 for K0823 PWCs resulted in a claim denial rate of 62.6 percent and an overall charge
Monday, November 8, 2010
HINGHAM, Mass. — NHIC, the DME MAC for Jurisdiction A, said last week the results of a review for claims paid in Q3 for K0823 PWCs resulted in a claim denial rate of 62.6 percent and an overall charge denial rate of 58.8 percent.
The review covered 952 claims submitted by 257 suppliers, of which 356 were allowed and 596 were denied. The primary reason for denial was incomplete documentation (63.2 percent), the DME MAC said, adding that it will continue the widespread prepayment review of these claims.