MSI audit and appeals

MSI audit and appeals

Schedule E is an appeal process that physicians may use to resolve issues relating to interpretation of fee codes listed in the MSI Physician’s Manual and MSI Physicians’ Bulletins. Doctors Nova Scotia may refer issues that require a policy or billing rule change to other committees for resolution.

What’s new?

Pre-payment assessment decisions can now be appealed. Also, the process now involves a two-tiered appeal process to resolve all disputes.

Time is of the essence

Each phase of the appeal process has strict timelines. If you miss a deadline, you will forfeit your right to appeal. You are responsible for reviewing claim submissions in a timely manner to ensure adherence to these timelines.

Pre-payment assessment

If your pre-payment assessment claims have been rejected or adjusted by MSI, you have the right to appeal MSI’s decision

Post-payment audit review

When MSI identifies billing issues through the audit process, they provide you with written notice. If you disagree with the audit result, you have the right to ask for a review.

If you require assistance navigating the audit appeal process, please contact DNS for help.

Contact

Jessica Moore
Compensation manager, Master Agreement and Fee Schedule
902-481-4922
1-800-563-3427 ext. 4922