Billing Corner:
Tactics Help Resolve Your Primary Vs Secondary Payer Challenges
Published on Mon Oct 29, 2012
Take timely corrective action if you discover an overpayment.Did you know that you're obligated to refund overpayments to payers regardless of primary-versus-secondary issues between the payers? If not, it's time for a refresher in how to navigate the often convoluted path to accurate primary-secondary payer claims. Beware: "Keeping an overpayment might be deemed to be fraud or a possible kickback" warns coding, billing, and practice management consultant Steven M. Verno, CMBS, CMSCS, CEMCS, CPM-MCS, in Orlando, Fla.Stay CompliantBoth the OIG's compliance guidance for physicians and its guidance for third-party billing companies address overpayment refunding. As a healthcare provider, you have a legal obligation to repay any discovered overpayments.If you discover an overpayment, your practice should be prepared to refund one of the payers -- or sometimes the patient -- the money due.Pointer: Don't send refunds to payers until you have specific information on where to send the money. When you find out [...]
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