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Refund & Recoupments
Many overpayments, such as duplicate payments or clearly erroneous payment amounts, are often easy to detect due to credit balances. More problematic, however, are refund requests received which request reimbursement for claims that appear to have been paid correctly by the carrier. Such requests may result from post-claim medical necessity reviews or from retroactively activated coding/bundling edits which may not be widely agreed upon within the billing industry. Learn how to contest unsubstantiated refund/recoupment requests and how various regulations read.
Topic Areas for Refund & Recoupments:
Identifying Incorrect Payments and Potentially Applicable Laws
The payment was posted long ago but now the payer wants it back. What are the payer’s rights to take back an overpayment? What are your rights to appeal. Read our information on potentially applicable laws related to refund/recoupment. . . .more >>
Contest A Refund/Recoupment
You believe the payment received was accurate and the law is on your side. Here are some tips on appealing a unjustified refund/recoupment. . . .more >>