Palmetto GBA is offering some tips and reminding providers of the process for appeals under the Review Choice Demonstration (RCD).
RCD does not include a separate appeal process for a non-affirmed pre-claim review decision, according to Palmetto.
“As a reminder, a non-affirmed pre-claim review decision does not prevent the home health agency from submitting a final claim,” Palmetto notes. “A submission of a final claim with a non-affirmed unique tracking number (UTN) and resulting denial by the Medicare Administrative Contractor (MAC) would constitute an initial determination on the claim that would make the appeals process available for disputes by beneficiaries and HHAs. Appeals will follow all current procedures no matter which RCD choice an HHA selects.”