Failure to understand a payer's billing requirements and not looking into whether other providers within an organization understand those requirements are the most common mistakes that lead to healthcare overpayment, according to Alice Harris, an attorney who specialized in healthcare reimbursement and compliance.
Below are the top five measures healthcare providers can take to avoid overpayment, according to Ms. Harris:
- Fully understand a payer's requirements before submitting claims.
- Verify billing guidance from colleagues, friends or third-hand advice.
- Conduct compliance due diligence before all sales.
- Audit all new providers' coding and documentation before they submit any claims.
- Invest in an effective compliance program.