Washington, DC (PRWEB) July 03, 2013
A Medicare audit of a Kansas physician group is raising eyebrows because the audit findings were employed by secondary payers to recoup their share of the purported overpayment, Atlantic Info Servicess Report on Medicare Compliance has learned. Published in the July 1 issue of the weekly newsletter, the physician groups knowledge is a reminder that the use of extrapolation is spreading.

Their business office manager has a two-foot-higher stack of secondary payer requests for repayment primarily based on the MAC [Medicare administrative contractor] audit, says Richelle Beckman, an lawyer with the Forbes Law Group in Overland Park, Kan., which represents the physician group. As soon as the MAC completed the audit and identified overpayments, all the secondary payers requested their share before the physician practice even received the MACs demand letter or had a chance to appeal the denied claims, she says. If and when the physician practice wins its Medicare appeals, it will have to battle each and every secondary payer separately utilizing whatever appeals process it has established.

Ernie de los Santos, CEO of the Appeal Academy in Los Angeles, thinks this is a cautionary tale for other providers. In this case, you dont know [the provider] is wrong however. You havent gone by means of due process and they are entitled to due process, he notes. It seems unfair to providers.

Check out http://aishealth.com/archive/rmc070113-01 to study the article in its entirety.

About Report on Medicare Compliance
The industry’s #1 supply of timely news and confirmed techniques on Medicare compliance, Stark and other large-dollar problems of concern to well being care compliance officers, the award-winning Report on Medicare Compliance identifies and offers worthwhile guidance on dozens of high-threat billing and documentation issues and foreshadows the subsequent moves of federal enforcers and their armies of RAC, ZPIC and MAC auditors. The best info there is for hospital compliance officers, the 8-web page weekly newsletter consists of insights and techniques not offered anyplace else.

Given that 1992, Report on Medicare Compliance has been written by Nina Youngstrom, who has a reputation for getting one of the most knowledgeable journalists and incisive writers in the field. With superb contacts at the IG’s workplace and at CMS, and powerful relationships amongst market specialists and compliance officers, every single situation of Report on Medicare Compliance consists of exclusive, inside news.

About AIS
Atlantic Information Solutions, Inc. (AIS) is a publishing and info organization that has been serving the well being care sector for much more than 25 years. It develops highly targeted news, data and strategic details for managers in hospitals, health plans, medical group practices, pharmaceutical organizations and other health care organizations. AIS items include print and electronic newsletters, internet sites, looseleafs, books, strategic reports, databases, webinars and conferences. Understand far more at http://AISHealth.com.





