JOHN691
New
We just received 2 large take back requests from BCBS from 2019-now on TOCs that they have previously allowed and paid for. It states ‘An overpayment was identified as the date of service billed did not follow CMS guidelines for billing Transition Care Management Services’ however no documentation has ever been submitted. One had 13 claims on it and another had 24, in addition to single take back letters over the past few months. Has anyone else had this happen to them or have any guidance since we are going through 40+ dates of service for TOCs?