Billing > Billing

Mcare take back code 132

(1/2) > >>

Kerri:
Has anyone had money taken back from Medicare for CO132...Pre arranged demonstration project adjustment.

So far I have five letters totaling approx. $2000.00.  The letters say "you billed and received payment for services for which you should have known you were not entitled to". The reason listed for the take back is "the claim was processed incorrectly, causing an over payment".  I called Medicare (40 minutes on hold and 20 while they looked for the claim)and was told that they couldn't see a reason for the take back. They escalated my question, whatever THAT means.

Today I got an EOB that has the CO132 on it and I wonder if it is related .  When I got the first one I called Medicare and was told ignore it it was just internal auditing, but now I wonder.....

Michele:
I have not personally seen this.  My research just indicates that they are "reducing payment".  You didn't indicate what services were billed.  If you believe the services were a covered benefit and that the reductions were in error I would call again.  Did they 'escalate' all 5 cases?  Or just the one?  Are there any other codes on the letter?

Kerri:
there is no specific code stated on the letter that they are taking away from.  It just says the DOS, the claim # and the amount they want back.  This isn't 5 cases, its five letters and approx. 50 patients. All varying procedures. 

Michele:
Wow!  Definitely need to get to the bottom of it.  What were the services?  Did they deny them in full or just reduce the allowed amount? 

kristin:
Found this: https://medicare.fcso.com/COB/0463261.asp

Does any of what that says apply to your particular issue? Personally, I have never heard of this denial code.

Navigation

[0] Message Index

[#] Next page

Go to full version