Results 1 to 3 of 3

Tricare REFUND Requests

  1. #1
    Thumbs down Tricare REFUND Requests
    Exam Training Packages
    We got a massive refund request (ASC) for 'overpayment' of several 2007 claims from Tricare Humana Military - South Region (Texas).

    According to rule 133.260, they only have 240 days to request a refund, or 30 days from audit (according to 133.230) on a processing claim.

    These claims have all been finalized two years ago.

    My question is: since this is a 'government' plan, are they handled differently?

    Thanks y'all!
    ~Dawn, CPC

  2. #2
    If I'm not mistaken, any of the government plans can request from as far back as they would like to.

  3. #3
    The bigger question, in my mind, is what triggered this request.

    The OIG work on some cases for years, so reading enforcement actions for the past few months you will see claims from 2002-2004 and other old date ranges just now being addressed.

    I know Tricare is slow to pay and process so it wouldn't shock me that they are slow to take back as well.

    Regardless of why it took so long or what caused it at all, I would take a good long look at the things they are looking at and make sure they are being done correctly now.

    Laura, CPC

Similar Threads

  1. RAC requests
    By MeBriggs in forum Auditing General Discussion
    Replies: 1
    Last Post: 05-13-2015, 06:29 AM
  2. Consultation Requests
    By H@wks F@n in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 01-20-2013, 07:40 PM
  3. Consultation Requests
    By mbabou in forum E/M
    Replies: 1
    Last Post: 07-23-2009, 02:17 PM
  4. Consult Requests
    By Gemini18 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 05-22-2009, 07:33 AM
  5. Appealing Refund Requests
    By cgrussell in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 04-01-2008, 10:24 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.