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November 27, 2000

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AdminaStar establishes special unit for claims review

By MICHAEL SWIFT
President-Elect, Kentucky Ambulance Providers Association

GLASGOW — David Elliott, Manager of Medicare Part B Provider Relations of AdminaStar-Federal, Inc. has contacted the Kentucky Ambulance Providers Association of a change in the previously communicated procedure for having claims that ambulance providers feel have been denied in error are to be handled for review rather than being submitted for appeal.

Mr. Elliott advised that a special unit has been established in Indianapolis to specifically handle ambulance provider's requests for reviews of claims felt to have been initially denied in error.

Effective immediately, claims for either emergency and/or non-emergency transportation that have been denied and that providers feel contained all of the necessary and appropriate documentation on the initial claim should be faxed to the following number in Indianapolis rather than mailed to Maureen Meeks in Louisville.

1. Providers must submit a copy of their EMOB with the claim in question circled to:

David Elliott Manager, 
Part B Provider Relations 
AdminaStar-Federal, Inc. 
FAX: (317) 841-4435

2. Claims that are currently being appealed can also be submitted to Mr. Elliott as long as there has not been any additional documentation submitted to AdminaStar for their consideration in the appeals process. If any additional information and/or documentation has been forwarded to AdminaStar, the claim must go through the appeals process.

Again, the advantage to providers utilizing this method over the appeals process is that AdminaStar has committed to a 30 day floor with this process as opposed to a minimum of 6-7 months for an appeal.

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