May 11, 2007
Denials and Certs
Nathan Kennedy, Part A and Part B lead, advised the top reasons for Medicare application denials were:
- Missing signature
- Wrong application completed
- Application sent to wrong carrier
- Missing signature of delegated official on file
Kennedy explained the Comprehensive Error Rate Testing Program (CERT) statistics for May indicated NGS had a 3.5 percent error rate for Indiana; expectations nationally are less than 4 percent. The provider response rate to the CERT letter was 100 percent. Kennedy extended congratulations to all physicians and their staffs. He also indicated:
- 81 percent of errors are evaluation and management related.
- 9 percent of the errors were for chiropractic services.
