When CMS overpays for services, providers and commercial payers are responsible for paying the agency back, and at times, they are on the hook for millions of dollars. But technology can help healthcare stakeholders catch the mistakes that lead to overpayments, thereby reducing unnecessary costs.
CMS recently revealed that the Patient-Driven Payment Model – intended to be revenue-neutral as compared to the previous payment model – increased reimbursements to SNFs last year by more than $1.7 billion, raising the specter of potential payment reviews around the corner.
The Office of the Inspector General will audit Medicare Part B telehealth services to detect potential vulnerabilities and ensure compliance with regulatory requirements. To prepare, providers must first take stock of their programs and conduct audits of their own, experts say.