Medicare Compliance & Reimbursement

Avoid these common mistakes so you won't have to refund your MAC. If you're billing an incorrect number of drug units on your claims, you could be collecting thousands more than you deserve -- and you need to pay it back. That's the word from the OIG, whose latest report was released on April 22. The report, entitled "Review of Medicare Payments Exceeding Charges for Outpatient Services Processed by Noridian Administrative Services, LLC, in Jurisdiction 2 for the Period Jan. 1, 2006 through June 30, 2009," shed some light on common mistakes that Part B practices make, resulting in millions in repayments to Medicare. The method: To complete its audit, the OIG reviewed line items submitted to Noridian (a Part B MAC for four states) that had either a Medicare payment amount that exceeded the billed charge amount by at least $1,000; or three or more units of service. The OIG [...]