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Understanding Basics of Medicare Overpayment

Medisys Compliance

What is Medicare Overpayment? An overpayment is a payment made to a provider exceeding amounts due and payable according to existing laws and regulations. Identified overpayments are debts owed to the federal government. Laws and regulations require CMS recover overpayments. Medicare Overpayment Collection Process.

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Enhancing Payment Integrity in Healthcare through Pre-Payment Reviews

Healthcare IT Today

It’s estimated that up to 80 percent of medical bills contain errors amounting to billions of dollars that are lost annually to payers. This reactive model leads to only ~70% of identified overpayments being recovered and/or corrected. Providers navigate abrasive recoveries and revenue instability.

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Fixing Medicare Advantage Payments

Healthcare IT Today

CMS requires chart reviews to catch overpayments. Reasons for chart reviews include: Finding clinical interventions that weren’t correctly billed, or perhaps weren’t billed at all. Figure 1: Dashboard showing a breakdown by year Chart reviews are independent examinations of patients’ clinical records.

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Navigating CMS UPIC Audits: A Guide for Healthcare Organizations

Compliancy Group

Through a combination of data analysis, investigations, medical reviews, and site visits, UPICs scrutinize healthcare providers and suppliers to ensure compliance with billing rules and the provision of medically necessary services.

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Health Provider News

Hall Render

to Study Treatments for Vascular Abnormalities Federal Appeals Court Hears Arguments on Nation’s First Ban on Gender-affirming Care for Minors Jason Demke Hired as COO at Mercy Hospital Fort Smit Pulaski Tech Awarded $5.7M Can lawmakers do anything about it?

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Preparing for Payer Coding Audits

Medisys Compliance

In the unfortunate event when you receive such overpayment demand letters, don’t acquiesce without conducting an analysis first. Medisys Data Solutions is a leading medical billing company providing complete medical billing and coding services.

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Health Provider News

Hall Render

Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass. Health Policy Commission still missing key document in Steward sale to Optum Local obesity drug developer lands deal worth up to $600M with Novo Nordisk Mass.