MRO Compliance

JANUARY 16, 2025

Many claims analysts feel that chasing down overpayments feels like plugging leaks in a sinking boat. By using real-time analytics and data validation tools, payers can catch errors before claims are paid, reducing overpayments, denials, and administrative friction. This is why payers are now shifting toward pre-pay accuracy.

Overpayments 130

Overpayments Overpayment Regulatory Compliance Patient Satisfaction 130

Medisys Compliance

JULY 5, 2022

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.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Healthcare IT Today

FEBRUARY 22, 2023

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.

Medicare 118

Medicare Medicare Overpayments Overpayment 118

Medisys Compliance

MARCH 7, 2022

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.

Medical Billing 52

Medical Billing Medical Billing Outsourcing Overpayments Overpayment 52

Healthcare IT Today

FEBRUARY 2, 2024

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.

Payment Systems 78

Payment Systems Overpayments Overpayment Medical Billing 78

Medisys Compliance

NOVEMBER 26, 2024

Common Issues Impacting SNF Billing Compliance Improper Payments: Errors in coding or documentation can lead to overpayments or denials. Medically Unreasonable Care: Billing for services not deemed necessary by Medicare standards results in claim rejections. Claims must reflect the terms of insurance contracts accurately.

Compliance 52

Compliance Medical Billing Outsourcing Medicare Medicare 52

Compliancy Group

FEBRUARY 7, 2024

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.

Fraud 52

Fraud Compliance Medicare Medicare 52