tci Medicare Compliance & Reimbursement - 2012 Issue 5

Industry Notes:OIG Offered Practices Second Chance to Submit Required Records, But Most Didn't Take It

You have most likely heard the phrase "if it wasn't documented, it wasn't done" so many times that it's old hat -- and yet, insufficient documentation remains one of the biggest denial reasons among Medicare contractors. The OIG tried to improve upon that denial rate by offering practices a second chance to turn in required documentation -- but the majority passed on the offer, leaving contractors no choice but to request a refund of the money that practices had received for those services. Background: When CERT (Comprehensive Error Rate Testing) reviewers find that Medicare paid for claims that are...

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