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专业评审组织(PRO)支付拒绝的申诉策略。

Strategies for appeals of PRO payment denials.

作者信息

Manning M M, Miller W J

出版信息

Med Staff Couns. 1990 Fall;4(4):21-5.

Abstract

Review of care furnished to Medicare patients by peer review organizations often results in denials of payment for services found not to be "covered" by the Medicare program. Providers should be aware that they can appeal these denials of payment, and that, at least at present, there is a good chance that such denials can be reversed on appeal.

摘要

同行评审组织对医疗保险患者所接受护理的审查,常常导致医疗保险项目认定为“未涵盖”的服务费用遭到拒付。医疗服务提供者应意识到他们可以对这些拒付提出上诉,而且至少目前来看,上诉后这些拒付很有可能被撤销。

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