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Denials: Tips from a former MAC reviewer

By Rachel Strom, RN
Yes, I’ll admit it, I used to be one of those people, I am a former Medicare Administrative Contractor (MAC) reviewer. Before finding a great fit in on a CDI dream team (or so I’d like to think we are), I worked as a Medical Review Examiner for a MAC contractor. During that time, I reviewed Part A claims for inpatient stays, therapy reviews, medications, and Recovery Auditor Contractor (RAC) appeals—to name a few.


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