Medicare Program Integrity: Increased Oversight and Guidance Could Improve Effectiveness and Efficiency of Postpayment Claims Reviews

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By Kathleen M. King (au)
Year: 2014
Pages: 62
Binding Paperback
ISBN 978-1-4578-5701-0

Product Code: 1457857014

Description

Several types of Medicare contractors conduct postpayment claims reviews to help reduce improper payments. Questions have been raised about their effectiveness and efficiency, and the burden on providers. Building on GAO's July 2013 report on postpayment claims review requirements, this report examines, among other things, the extent to which the Centers for Medicare & Medicaid Services (CMS) has (1) data to assess whether contractors conduct duplicative postpayment claims reviews; (2) requirements for contractor correspondence with providers to help ensure effective communication; and (3) strategies for coordination of claims review activities. Tables and figures. This is a print on demand report.

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