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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_34 | Pages 301 - 301
1 Dec 2013
Barnes L Edwards P Newbern DG
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PURPOSE:

Medicare intermediary denial of primary joint replacements has become common over the past couple of years. Our community hospital had a marked increase in denials following the assignment of a new intermediary. Our purpose is to document the initial impact of these denials.

METHODS:

A retrospective review of the first 361 Medicare total joints (181 hips and 180 knees) after a new intermediary began processing claims was performed. Initial denial rate, positive response rate to first appeal, as well as delay in payments because of these denials were documented