Guys, (only serious responses please)
I am interested in the connection between your ALJ decisions and your overall post decision payments. Here is the scenario in question. When you have appealed to the ALJ level and waited your two years. After you win your judgement, has CMS:
1) Reimbursed you what they recouped, plus interest, or have you had issues of CMS then refuting what they owe in spite of the judgement?
2) Have they claimed that some codes in the original claim set were non-medically necessary?
3) Has CMS stated that you did not include all of the codes in the original claim set with your ALJ level of appeal?
4) In other words, has CMS recouped money, and then when it was time to pay the money back, have they found some reason to keep some, or all, of your money?
PLEASE ONLY RESPOND WITH REAL SCENARIOS THAT YOU CAN PERSONALLY REPRODUCE.
Carey Jinright, LO, MSM
“WDJD”
Be an example, not an excuse!
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