In Billing
Apr 16th, 2018
Medical coders and billers aren’t the only ones getting over-payment letters from the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) these days. The State of Idaho is in hot water, accused of receiving $3.1 million too much between 2010 and 2013. OIG Audits Idaho According to an audit by the ...
In Audit
Jun 8th, 2016
The Centers for Medicare & Medicaid Services (CMS) has made a number of changes to the Recovery Audit Program for 2016. One of those changes is the length of time a provider has to submit a Discussion Request to a recovery audit contractor (RAC) following an automated review. CMS is also establishing Additional Documentation Request ...
In Billing
Feb 16th, 2016
A final rule, issued by the Centers for Medicare & Medicaid Services (CMS) on Feb. 12, clarifies reporting and repayment obligations for providers and suppliers who receive a Medicare overpayment. The final rule explains, “a person has identified an overpayment when the person has or should have, through the exercise of reasonable diligence, determined that the ...
In Billing
Jun 15th, 2015
by John Verhovshek, MA, CPC As part of an active compliance program, your practice should take steps to identify and, where appropriate, return overpayments. Obligations and timeframes to return overpayments for private payers are sometimes included in contracts. The Medicare program includes program manual instructions on overpayments. In most cases, overpayments are returned to the ...
In Billing
May 12th, 2015
By Nancy Clark, CPC, CPC-H, CPB, CPMA, CPC-I The Office of Inspector General issued a report indicating that reimbursement is owed to its Medicare Administrative Contractors (MACs) due to incorrect place of service (POS) coding. During the period from January 2010 to September 2012, many physicians’ claims erroneously showed that services performed in facility locations, ...