Practice Management Alert

Question: Some insurers are deducting overpayments from our checks for visits or services rendered. Are payers allowed to do this, and do we really have to pay back overpayments? Florida Subscriber Answer: As a healthcare provider, you're legally obligated to repay overpayments when you or the payer discovers the mistake. Due to the large number of claims a provider submits each month and the complex nature of payer regulations, overpayments are bound to happen. Your office should have a system for repaying overpayments, or at least include a credit balance report with end-of-month reports. Take the following steps when setting up an internal auditing system: Step 1: First, be sure the overpayment amount isn't a payment-posting mistake before you refund any money. If it's a legitimate overpayment, determine how it happened and how to avoid it in the future. Step 2: Contact the insurer to confirm you understand its policies [...]