Tag: Overpayment
Fix overlap flap, AAH tells CMS
January 9, 2013Theresa Flaherty, Managing Editor
BALTIMORE - AAHomecare has gone to bat for HME providers who are losing out on monthly payments from Medicare for claims that overlap inpatient stays.The association, which discussed the problem with CMS recently, says Recovery Audit Contractors (RACs) are seeking recoupment on claims when the anniversary billing date overlaps with a patient's stay in a hospital, skilled nursing or other facility—even if the patient uses the equipment nearly every day during that month.“This is a threat...
OIG to Pos-T-Vac: 51% of claims were no good
June 19, 2012HME News Staff
DODGE CITY, Kan. - The Office of Inspector General (OIG) this week recommended that Pos-T-Vac Medical, a manufacturer and supplier of male vacuum erectile systems, refund $4.2 million to Medicare for claims that should not have been allowed.The OIG reviewed 100 claims and found that 51 claims worth $18,007 did not comply with documentation requirements. It then extrapolated those results to all claims submitted from Jan. 1, 2008, through Dec. 31, 2009.Medicare paid Pos-T-Vac $8.5 million for male...