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Report calls out Medicare Advantage for lack of info on claims denials

Posted On: Mar. 6, 2023 10:08 AM CST

Medicare Advantage plans are not required to identify when claims were denied, hindering fraud, waste and abuse investigations, according to a new report from the Department of Health and Human Services’ Office of Inspector General, Becker’s Payer Issues reports. Unlike fee-for-service Medicare and Medicaid, Medicare Advantage plans do not have to indicate which claims are denied in encounter records.