• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Wiki Should my office notify Medicare of a billing error for sedation codes?

Create Wiki
M

MSCPCNG

Guest
Messages
13
Location
Anchorage,Alaska
Best answers
0
I am trying to locate a real person employed by Medicare, possibly a local Alaska State rep. My question is, should I notify Medicare of an error that the office found an error in the number of units of a specific CPT we have billed to CMS. The last office I worked at we contacted our CMS rep. I am new to Juneau and we are pretty limited in resources. Any suggestions would be helpful. Thank you in advance.:)
 
If you have identified a billing error that has caused an overpayment, especially recurring, your should DEFINITELY talk to your administrator and complaince officer/attorney about informing Medicare. If the overpayment is substantial and you can calculate the amount of overpayment then you can send a refund check to Medicare with the Voluntary Refund Form with an attachment identifying each patient/HIC/DOS/ICN/amount of line item refund. If you are unable to calculate the overpayment amount then you should contact your Medicare carrier and report the issue and ask for guidance.

I googled Alaska Medicare Part B and I came up with Noridan. If this is your correct carrier below is their contact information. In addition, I have added the link to their Voluntary Refund Form.

Provider Contact Center
Available Monday – Friday,
8:00 a.m. – 4:00 p.m. in Respective Time Zone (800) 933-0614


https://www.noridianmedicare.com/p-medb/forms/docs/ref_med.pdf

Julie, CPC
 
Last edited:
Julie,
Thank you for your reply and info. I called Noridian before I sent out the email and they suggested I call and request the phone reopening line. This is for changes such as units, modifiers, month and day changes, ICD-9 and CPT codes if down coding. I am not familiar with this process and I will check into it. I do not think we will have to refund any payments because Medicare has denied for wrong # of units. I am in the process of doing an audit on these codes for the past year and half.
I am new to this office (Orthopedic Surgeons and PT) and I am working on trying to show them the importance and need for a compliance/quality person. This is a small office and training and education is only through travel to the mainland or via the Web. It is a challange to get staff to trust me when I try to educate them. I find I have to take very small steps and always back up my info with a hard copy of the info.
Thanks again for your assistance.:)
 
Whenever I submitted a claim with errors to an insurance company, I called the company to explain the error and obtained the name of a contact person/supervisor. I then printed out a corrected claim and sent it with a letter addressed to the contact person explaining the error and the reason for the resubmission. I have had no problems yet.
 
You must log in or register to reply here.
Top