[Jamie Hagan]

Did anyone else see on their ERN today from Medicare a lot of Recoups from the past three years trying to state OA-109 and that they are requesting repayment? From what I can see they are wrong on what they sent anyways in regards to stating that they were with another payer.

[KassDavis]

This happened to us a few months ago. Most of ours were rental patients that had actually been in a SNF on the date of service.

[DeeDee]

I received my remittance like this today... I will have to start looking into it.

[HEATHER]

You're right they are usually all patients who were in a SNF on your date of service. They might have been d/c a day late or went back into a facility w/ rental equipment. You can call a Medicare CSR and they will tell you the admit date, d/c date and the NPI of the facility they were in. You can then resubmit (if possible) based on those dates. Of course if they were in the SNF for the entire calendar month - you can't bill for that month. I think they will tell you 3 people at a time. And once a year we get a big recoupment request that has year(s) old claims on it.

[KassDavis]

Also if it is rental equipment, you can add the month the patient was in the SNF or hospital to the rental months, it will take awhile but eventually you will get back the money that was recouped.

[misbell]

Do they take this large recoupment from one check? Some of my claims go back to 2007. What can be done about this? Most of my claims say they were in SNF.

[HEATHER]

Besides the EOB's on your remittance you should also get a Recoupment Request in the mail. You can either pay it in full or submit a request for a repayment plan within 30 days. If you don't send in either they will start charging interest and can deduct the entire amount from your check after about 5-6 weeks from 1st notice. You can submit an appeal - but it is my understanding this appeal will not delay the recoupment.

[Regina]

I am in region A and received a pile of recoup letters in the last week. I have been trying to fax for offsets, usually unsuccessfully. Anyone else in region A having this issue? They need to get more fax lines if they are going to send out mass recoupment letters.

[Jamie Hagan]

I don't know about everyone else, but I have seen more recoups on SNF so far this year than I can ever remember, It is absolutely killing me and cash flow right now! We can be told immediately if someone is Deceased on DOS and if there is a change in their Insurance and deal with the issue right then. Why can't it be the same if someone goes into a SNF instead of two years later and recouping thousands of dollars when we could deal with the issue right then? Computer age that far behind at Medicare? I know, it's Medicare deal with it but I just needed to vent.

[DMEisgoodfun]

I know you were just venting but here's what we do to be proactive. At
intake when we find out this is a discharge, we get the discharge date. Then
we call the facility the day after the scheduled discharge and verify they
were truly discharged. If so, post for discharge date (if within 2 days).

On occasion we've billed to find out the patient didn't discharge for
another week. If we get documentation from the facility showing they
unexpectedly kept the patient longer, we've appealed and won.