Medicare Overpayments: Now what? What do you do and when do you do it?
Duration: 90 Minutes
The course will cover all aspects of overpayment, identification of overpayment on the organizations part, overpayment and demand bills from Medicare. What to do if you believe the over payment demand is in error.
Objectives of the Presentation
Why Should you Attend
- What is Medicare overpayment
- Common errors creating overpayment
- What penalties may apply
- What actions to take once a Demand Bill for Overpayment is received
- Difference between a demand bill for over payment and an organizations identification of Overpayment
Preserving revenue is essential to ensure quality of care. Services are provided with the belief and expectation that what was provided was needed and correctly billed for. This course will help you ensure that when you receive a demand bill you have reviewed the request, taken the appropriate steps and done what needs to be done to ensure that the smallest amount of revenue is returned to Medicare.
Who can Benefit
- Identification of Overpayment (internal) VS Demand Bill for Overpayment (external)
- Demand Bills related to Medicare as a Second Payer?
- Penalties; CMS plus civil
- The look back period- how far back can CMS look
- Reasonable diligence- what is this and how does it impact
- Auditing for identification -necessary
- Any organization that participates Medicare, CFO, Administrators, CEO's, Department Heads for Bookkeeping and billing departments
- Any Participant in the Medicare Programs : Hospitals /Skilled Nursing Facilities/ Physician's offices/Outpatient Clinics
In efforts to ensure proper payment and to reduce fraud and abuse increased oversight has occurred. Under the new Final Rule Overpayments have been targeted. The expectation for CMS contractors to identify overpayments as well as for the organizations to self audit is present. Knowing expectations and processes help organizations to ensure they are compliant and reduce their risk for overpayment and any potential penalties.