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Voluntary Refunds

  1. #1
    Location
    Overland Park, KS
    Posts
    1,166
    Exclamation Voluntary Refunds
    Medical Coding Books
    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.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  2. #2
    Location
    Evansville Indiana
    Posts
    451
    Default refunds
    All errors have to be refunded to CMS within 60 days of discovery, per their policy.
    LeeAnn

  3. Default 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...

  4. #4
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks to both of you! Where would I find CMS rules for voluntary refunds.
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

  5. Default
    Quote Originally Posted by dballard2004 View Post
    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!

  6. Default
    Quote Originally Posted by 021402 View Post
    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/text....1.4.6&idno=42

  7. #7
    Location
    Overland Park, KS
    Posts
    1,166
    Default
    Thanks!
    Dawson Ballard, Jr., CPC, CEMC, CPMA, CCS-P, CPC-P, CRHC, AAPC Fellow
    Coder

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