We have been audited on the hospital side. We have fought several and won.
The problem we are having is they take their money back before we even get notice that they think there is an overpayment. They aren't supposed to take anything back for like 45 days or something like that. We haven't had a modifier issue yet but we have had several number of units and couple of supplies that fall under the 72 hour issue. Most have been resolved with a single phone call. So I would suggest you fight it if it is correct.
Laura, CPC, CPMA, CEMC
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