I just got a letter from ZPIC, in which they deny audited claims because they "did not meet the medical necessity or/and documentation requirements." While, ZPIC quotes an overstatement amount in the letter, in an "action required" paragraph they note that NGS (Medicare claim administrative contractor) letter will follow with "the actual payment determination." Since appeal deadlines are very tight, what should I do right away in preparation for that letter from NGS?
Gather the billing documents in paper form and determine whether you're correct. If your people gave you bad data, send corrected statements. If you're right have a good administrative lawyer help wire your appeal.
Years licensed, work experience, education
Peer endorsements, associations, awards
Publications, speaking engagements