Overpaid? Send it back, and quickly – Ophthalmology Management
Recent actions by payers and law enforcement have changed the landscape regarding refunding overpayments — and not in ways that favor practices. Importantly, two recent precedents make it clear that you no longer can “investigate whether the overpayment is real” before determining that the 60-day window is implicated; it begins immediately. Here is an update on what you need to know.
This article addresses the following subjects:
- What is an overpayment?
- What happens when an overpayment is found?
- How should we handle refunds?
- What about related copayments and deductibles?
- Is refunding an overpayment sufficient to address the problem?
- Does refunding an overpayment lead to an audit?
- Do we need an attorney to make a refund of an overpayment?
- Should we report overpayments to the Office of Inspector General?
This article was published in Ophthalmology Management’s Coding & Reimbursement column, which is written by Corcoran’s Executive Vice-President, Suzanne Corcoran, COE. To view the entire article in Ophthalmology Management, click on the link below: