Friday, May 20, 2022

NURSING HOME RECOUPMENTS RESCINDED

Mike Rieth, LPO

Dear List,

I guess it pays to be the squeeky wheel. As of today, I received a withdrawl request for recoupment of my prosthtic claim, for a patient in a nursing home. From what I am hearing, Connolly Healthcare is rescinging these requests for repayment.
Last week I sent them chapter and verse from the Medicare Manual…and seems they are not denying these claims any longer.

I asked Medicare who is monitoring Connolly and they flat out told me no one. Medicare is telling us to send to redetermination or appeal the claim, and I’m telling all of you, not to do this! If Connolly is wrong and not doing their job correctly, you need to make them step up to the plate and do the job right! Don’t stand for the appeal process, as you and I both know this can take months if not years, call them out on it, show them chapter and verse from the manual, and make them correct their mistakes. Don’t let your claims get tied up jumping thru hoops you shouldn’t have to! Ask for a supervisor, email..Racinfo.com, call them back over and over til you speak to someone and if you are not getting resolution..go to the president of the company if you have to. I, personally had a nice longggggg conversation with him last week, and he is not unapproachable…very likable man, and seems to me..my problem was fixed pronto once I had him on the phone.

Morale of this story..Connolly Healthcare doens’t always know what they are doing. Must be a learning process for them also..so stand up for your rights folks!

Best Wishes!

Nancy McKay
Director of Reimbursement

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