Wiki Voluntary Refunds

[dballard2004]

Does anyone know if CMS has a policy on voluntary refunds? What I mean is if we do an audit and discover we coded the E/M level incorrectly and want to refund the money voluntarily to CMS, do they have a policy on how to do this? Thanks.

 

[cheermom68]

refunds

All errors have to be refunded to CMS within 60 days of discovery, per their policy.
LeeAnn

 

[Love Coding!]

OIG Guidelines are vague

In regards to overpayments, the previous reply is correct you have 60 days to refund upon discovery.

The OIG does not detail what type of discoveries in order to refund. I do internal documentation audits and I compare them to the ICD-9 codes selected and the CPT codes billed. I also had that in the back of my mind for a while. Our intent of these audits is for education...

 

[dballard2004]

Thanks to both of you! Where would I find CMS rules for voluntary refunds.

 

[Love Coding!]

Thanks to both of you! Where would I find CMS rules for voluntary refunds.

Here is a condensed version of the OIG Volunatary Compliance Program Steps
http://www.vsb.org/sections/hl/compliance.pdf

And here is the actual OIG Voluntary Compliance Program from the Federal Register
http://oig.hhs.gov/authorities/docs/physician.pdf

Refer to page - 59443
Step Five: Responding To Detected Offenses and Developing Corrective Action Initiatives

I hope this helps..good luck!

 

[Love Coding!]

Here is a condensed version of the OIG Volunatary Compliance Program Steps
http://www.vsb.org/sections/hl/compliance.pdf

And here is the actual OIG Voluntary Compliance Program from the Federal Register
http://oig.hhs.gov/authorities/docs/physician.pdf

Refer to page - 59443
Step Five: Responding To Detected Offenses and Developing Corrective Action Initiatives

I hope this helps..good luck!

Here is another link - refer to 433.316 on overpayments

http://ecfr.gpoaccess.gov/cgi/t/tex...gn=div6&view=text&node=42:4.0.1.1.4.6&idno=42

 

[dballard2004]

Thanks!