Michelle,
My provider is a chiro.
They say they overpaid due to the number of services.
Here is a letter he has created for part of it (I took out patient data etc). Will this work? ANd should we include the XRAY report and exam findings? What else do we need to do and how do we go about this correctly?
To: Medicare PA
Date: 1/19/2010
RE: Overpayment for services.
I have received your letter stating that overpayment was made. After careful review of the letter sent. I disagree with the determination that there was overpayment.
The first claim was XXXXXXXXXXXX For JANE DOE Hic No. XXXXXXXXX
The reason for overpayment was given as incorrect information concerning the number of services or entry of charges.
On December 17, 2007 Ms. XXXX reported neck pain dizziness and hip pain.
Based on her exam and X-ray findings she was adjusted at Occiputt, Cervical 1, Cervical 5, thoracic 2, thoracic 6, and thoracic 10 Lumbar 4, and Sacral Left
The code that was submitted was 98941. That is appropriate for this number of areas adjusted.
On December 19, 2007 Ms. XXXXX reported neck pain dizziness and hip pain.
Improvement was noted due to previous adjustment.
Based on her exam and X-ray findings she was adjusted at Occiput, Cervical 5, thoracic 2, thoracic 6, Lumbar 4, and Sacral Left
The code that was submitted was 98941. That is appropriate for this number of areas adjusted
On December 21, 2007 Ms. Keller reported neck pain dizziness and hip pain.
Based on her exam and X-ray findings she was adjusted at Cervical 1, Cervical 5, thoracic 6, and thoracic 10 Lumbar 4, and Sacral Left
The code that was submitted was 98941. That is appropriate for this number of areas adjusted.
On December 26, 2007 Ms. XXXXX reported neck pain dizziness and hip pain.
Based on her exam and X-ray findings she was adjusted at Cervical 5, thoracic 5, and thoracic 10 Lumbar 4, and Sacral Left
The code that was submitted was 98941. That is appropriate for this number of areas adjusted.
On December 28, 2007 Ms. XXXX reported neck pain dizziness. Improvement was noted in her symptom due to previous visits.
Based on her exam and X-ray findings she was adjusted at Cervical 1, Cervical 5
The code that was submitted was 98940. That is appropriate for this number of areas adjusted.
Each day the patient was adjusted based on her X-ray examination findings. The number of sites listed do correlate to the number of sites adjusted. The care was appropriate and reasonable.
Dr. XYZ
Doctor of Chiropractic
Board Certified Clinical Nutritionist