What are Overpayments?
Overpayments are Medicare funds a physician or beneficiary has received in excess of amounts due and payable under Medicare statutes and regulations. Provider overpayments are generated from a number of sources. Some examples are:
- Claims filed in error
- Services not rendered
- Services not medically necessary
- Coding/billing errors
The most common cause of beneficiary overpayments is paying the beneficiary for an assigned claim instead of making payment to the provider. In these instances, we must go to the beneficiary to recoup the money.
Cahaba performs recoupment services for Medicare Part B in Alabama, Georgia and Tennessee. See the Repaying a Medicare Overpayment/Provider Recoupment Procedures for more specific information.