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Recovery Auditor Improper Payments Ratchet Up

James Carroll, for HealthLeaders Media, October 3, 2012

"These are all gross numbers that do not show the amount of money that was overturned in appeals," he says.  "While reporting over- and under-payment information is important, it contributes to confusion in the industry over the appropriateness of billing. Not to mention that the cost of managing these audits and appeals is taking away taxpayer dollars from the delivery of healthcare."

"To take money back when the standards are clear is appropriate, but to take money back when there isn't clear guidance from the beginning is inappropriate and doesn't take into account the significant administrative and operational burden these audits and appeals place on healthcare organizations."

James Carroll is associate editor for the HCPro Revenue Cycle Institute.
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