What is considered non-compliance by the ordering physician with regard to supplying medical documentation?
Any failure to respond to a request from CMS for documentation that supports the charges on a claim would be considered non-compliance. 1833 (e) of the SSA, and 42 CFR 424.5(a)(6) prohibit Medicare payment for any claim that lacks the necessary information to determine whether payment is due and the amount of payment.
Related Questions
- Where is it in writing that I have to have progress notes or documentation in addition to the Certifying Statement of Physician to support medical necessity?
- Who can sign the Medical Documentation forms? It is okay if the physicians nurse approves the food/formula prescription?
- What is considered non-compliance by the ordering physician with regard to supplying medical documentation?
