Learn UM Skills

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    • Introduction
    • About Me
  • Utilization Management
    • UR or UM?
    • Medical Necessity Review
    • Perform UR & Ask ???
    • Timelines for Decisions
    • Determination Notices
  • Medi-Cal and Medicare
    • Medi-Cal Overview
    • Medi-Cal Updates
    • Medi-Cal Resources
    • Medicare Overview
    • Medicare Updates
    • Medicare Resources
  • Learn More
    • MCO, Plan, Product
    • Urgent vs Emergent
    • Glossary of Terminology
    • Other Resources
  • Contact
  • More
    • Home
    • Overview
      • Introduction
      • About Me
    • Utilization Management
      • UR or UM?
      • Medical Necessity Review
      • Perform UR & Ask ???
      • Timelines for Decisions
      • Determination Notices
    • Medi-Cal and Medicare
      • Medi-Cal Overview
      • Medi-Cal Updates
      • Medi-Cal Resources
      • Medicare Overview
      • Medicare Updates
      • Medicare Resources
    • Learn More
      • MCO, Plan, Product
      • Urgent vs Emergent
      • Glossary of Terminology
      • Other Resources
    • Contact

Learn UM Skills

Learn UM SkillsLearn UM SkillsLearn UM Skills
  • Home
  • Overview
    • Introduction
    • About Me
  • Utilization Management
    • UR or UM?
    • Medical Necessity Review
    • Perform UR & Ask ???
    • Timelines for Decisions
    • Determination Notices
  • Medi-Cal and Medicare
    • Medi-Cal Overview
    • Medi-Cal Updates
    • Medi-Cal Resources
    • Medicare Overview
    • Medicare Updates
    • Medicare Resources
  • Learn More
    • MCO, Plan, Product
    • Urgent vs Emergent
    • Glossary of Terminology
    • Other Resources
  • Contact

Medicare Turnaround Times (TAT)

ICE Medicare TAT Standards Matrix dated 6/10/2011 and retrieved on 3/28/2021)

ICE_UM_TAT_CMS_Standards_6-10-11 (1) (doc)

Download

Medicare Notice of Non Coverage (NONC)

ICE Medicare Denial Reason Matrix Examples (dated 3/20/2016 and retrieved on 3/28/2021)

ICE_Medicare Denial Reason Matrix (docx)

Download

CFR §414.210- Reasonable Useful Lifetime

Title 42 → Chapter IV → Subchapter B → Part 414 → Subpart D → §414.210

Payment for Durable Medical Equipment and Prosthetic and Orthotic Devices

General Payment Rules (see page 2 & 3 for RUL)

eCFR General Payment Rules-RUL Replacement, etc (pdf)

Download

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