Tuesday, May 22, 2012

The Medicare Overpayment Collection Process

Need guidelines on The Medicare Overpayment Collection Process?

The Centers for Medicare and Medicaid Services (CMS) produced a short fact sheet on "The Medicare Overpayment Collection Process" in July 2011.

According to the CMS, The definition of a Medicare Physician or Supplier Overpayment is:

"A payment that a physician or supplier has received in excess of amounts due and payable under Medicare statute and regulations. Once a determination of an overpayment has been made, the amount of the overpayment becomes a debt owed by the debtor to the Federal government. Federal law requires the Centers for Medicare & Medicaid Services (CMS) to seek the recovery of all identified overpayments."

In Medicare, physician or supplier overpayments occur due to: 
  • Duplicate submission of the same service or claim;
  • Payment to the incorrect payee;
  • Payment for excluded or medically unnecessary services; or
  • A pattern of furnishing and billing for excessive or non-covered services.

The Overpayment Collection Process

  • Demand Letters
  • Repayment Plans
  • Rebuttals
  • Appeals
Additionally there are links to external websites regarding Medicare Overpayments and the collection process.

To download and view the full fact sheet, please go to the following link: The Medicare Overpayment Collection Process Fact Sheet

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