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Common mistakes in Medicare overpayment cases

Allegations of a Medicare overpayment are not uncommon. The government estimates that it overpays millions in Medicare claims to physicians and healthcare providers every single year. The government states these overpayments are of the result of a place-of-service coding error by physicians and a failure on the part of Medicare contractors to identify and recoup the overpaid claims.

When it uncovers an alleged overpayment, the government will send the physician or group a demand letter. The aptly named letter generally outlines the alleged error and demands the group return the excess payment.

Those who receive these letters are wise to take them seriously. Some common mistakes that can snowball into bigger problems include:

  • Ignoring the letter. It will not go away. A failure to take the notification seriously can lead to additional penalties and fees.
  • Not checking for deadlines. The demand letter will have a lot of information. Focus in on dates. A failure to meet deadlines can mean you limit your options for recourse.
  • Failing to explore options. Getting a demand letter from the government is intimidating, but it is not the final word in the matter. The government makes mistakes, and it is entirely possible the overpayment allegations are wrong. Those who believe there could be an error can pursue an appeal.

Another common mistake to avoid is going through the process without legal counsel. An attorney experienced in this niche area of the law can review the alleged overpayment and discuss your options, better ensuring your practice or group is protected throughout the process.

Attorney John Rivas is responsible for this communication