While receiving several claims reimbursed from Medicare, I came across several medical coding mistakes that resulted in the clinic receiving overpayments. When I brought it up to the office manager, she dismissed it and said it was Medicare's fault, not the clinics. How should I handle this situation?
Flower
I am sure that the clinic deliberately gave incorrect coding in order to get more money reimbursed from Medicare. They all overbill Medicare.If you are honest you should report the overpayments to the Centers for Medicaid and Medicare.
Valentine
You should contact Medicare about the overpayment. They have a process set in place to return money. They will eventually notice and request it back, so you might as well do it now. I am not sure if there is a lead physician you can go to on this or not, but dismissing it is not the correct way to handle this.
And while overpayments do happen, unlike what the other poster suggested, clinics DO NOT do this on purpose to get one over on insurance or the patients. Mistakes happen, we are people, not computers.
mbrcatz
It needs to be reported to Medicare.
This is a perfect example of why Medicare has a 30% fraud rate.
liveinmd
I have my CPC (professional coder), this is serious stuff. report it to Medicare NOW. Whether it is intentional or accidental, it is a problem and let Medicare straighten it out.
Orignal From: Q&A: While receiving several claims reimbursed from Medicare, I came across several coding mistakes that resulted?
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