LouiseR1
Guru
Has anyone successfully appealed a recoupment? For example, Humana is recouping 1/2 of their original payment because they misprocessed it based on the multiple surgery rule. But I have had a consultant tell us that "courts have generally ruled that insurance companies may not be entitled to refund payments that result from a mistake made by the insurer. Contrarily, legal statutes stipulate that healthcare providers are innocent parties and that the party who created the loss must incur it." is it worth spinning our wheels?
any input or stories of victories would help
thanks,
Louise CPC
any input or stories of victories would help
thanks,
Louise CPC