RECONSIDERATIONS C2C INAPPROPRIATE DENIALS

RECONSIDERATIONS C2C INAPPROPRIATE DENIALS

January 28, 2014

Due to the high increase in denials from C2C statingdocumentation was not received when it is clearly a part of the documentationyou sent.

Jurisdiction D DAC has contacted the CMS COR over the C2Ccontractor and they have requested examples of these types of denials.

REGARDLESS of what jurisdiction you are in please send anyexamples you may have to [email protected]or [email protected] andwe will forward the information to the D DAC

NEED:  The Appealnumber and exactly what and why it was denied pointing out the denial reason

Such as — Denial was “The order submitted with theredetermination request does not include (the dosage of the medication or routeof administration or the progress notes did not include the height and weightof the patient”  State where on yourdocumentation the correct information is found (page X  of has the ______)  

Please send any and all examples you have pertaining to C2Csolutions.

Thank you

Peggy Walker, RN

Director of Reimbursement Services

US Rehab/VGM

800-401-3643