{"id":7844,"date":"2022-07-05T16:59:13","date_gmt":"2022-07-05T11:29:13","guid":{"rendered":"https:\/\/www.medisysdata.com\/blog\/?p=7844"},"modified":"2022-11-02T14:44:18","modified_gmt":"2022-11-02T09:14:18","slug":"understanding-basics-of-medicare-overpayment","status":"publish","type":"post","link":"https:\/\/www.medisysdata.com\/blog\/understanding-basics-of-medicare-overpayment\/","title":{"rendered":"Understanding Basics of Medicare Overpayment"},"content":{"rendered":"

What is Medicare Overpayment?<\/h2>\n

An overpayment is a payment made to a provider exceeding amounts due and payable according to existing laws and regulations. Identified overpayments are debts owed to the federal government. Laws and regulations require CMS recover overpayments. This fact sheet describes the overpayment collection process. A Medicare overpayment exceeds regulation and statute properly payable amounts. When Medicare identifies an overpayment, the amount becomes a debt a healthcare provider owes the federal government. Federal law requires CMS recover all identified overpayments. Medicare overpayments happen because of incorrect coding; insufficient documentation; medical necessity errors; and processing and administrative errors. The Medicare Secondary Payer<\/a> (MSP) program is in place to ensure that Medicare is aware of situations where it should not be the primary, or first, payer of claims. In certain situations, after a Medicare claim is paid, CMS receives new information indicating Medicare has made a primary payment by mistake. Based on this new information, CMS takes action to recover the mistaken Medicare payment.<\/p>\n

Medicare Overpayment Collection Process<\/h2>\n

After provider or billing team identifies the overpayment, they must report and return a self-identified overpayment to Medicare within:<\/p>\n