Feb 13, 2012

TrailBlazer Review Causes Claims Denials

The Centers Medicare & Medicaid Services has ordered all of its contracting administrators to review Medicare Part A/B claims for completeness and documentation related issues. Trailblazer, the administrator for Texas, announced late last year it would review knee and hip joint replacement surgery, among other procedures. Trailblazer says its review showed cases where the necessary information is missing or the documentation is otherwise insufficient. This means TrailBlazer will deny payment for both Part A and B services and ask physicians subject to the review to return any amount already paid for the service.

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