Physician Consultant
Current
Steve Edelson Md
I provide physician review services for CMS audits of Medicare advantage plans parts C and D. At those audits I review the medical records and participate in the discussion of denied cases. After the meetings I review the documentation with the audit team to assess if the denials are consistent with Medicare regulations as well as the individual plan guidelines. I also attend quarterly meetings with the lead physician at CMS to discuss interesting or unusual cases.DRG coding reviewsSocial Security disability reviews
2022 - Present
~4 yrs 7 mos