Frequently Asked Questions

What are some of the common errors that affect reimbursement of Part B services by Medicare?

1. Missing or invalid information such as:

• Incomplete or invalid medical record documentation ( progress notes, discharge summaries, etc.)
• Orders
• Dates of service
• Mismatch between patient name and ID number
• Practice identifying information
• Clinical Laboratory Improvement Amendments (CLIA) certification number

1. Non-compliance with Teaching Physician (TP) requirements
2. The provider was not eligible or certified to be paid for the service or procedure on a given date of service