Outpatient Surgery Magazine - Subscribers

Battle Post-op Pain Without Opioids - April 2016 - Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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3 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 6 I t's hard enough to get your claims paid correctly. But to then receive a refund demand several months or even years after you submitted the initial claim presents a whole new challenge. There is a way to fight back against medical record audit requests and refund demands from payers or their third-party contractors. Often, these attempts by insurers fail to meet various payer compli- ance requirements that help protect revenue rightfully earned for your services rendered in good faith. Compliance is a two-way street, and payers are not exempt from claim-handling obligations. If you're fac- ing refund requests or notifications of recoupment, here's what you need to know. When Payers Demand Refunds and Takebacks Strategies to fight back and protect what's rightfully yours. Coding & Billing Karlene Dittrich, CBCS, CPMA • TUG OF WAR More and more payers are demanding refunds and givebacks from facilities.

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