Ecklund Jennifer Rudenick, Cookingham Andrew
Healthc Financ Manage. 2014 Jun;68(6):50-5.
Healthcare providers increasingly face the prospect of losing revenue to recoupment, a process by which insurance carriers reduce payments to make up for alleged overpayments on prior claims. Carriers often are unclear about their reasoning for alleging an overpayment was made and about their methods of recouping the overpayment, as well as providers' opportunities to appeal the determination. Providers can use various strategies to mount an effective appeal of an overpayment claim and should be sure their appeal is timely and comprehensive.
医疗服务提供者越来越面临收入被追回的风险，在此过程中，保险公司会减少支付金额以弥补先前索赔中所谓的多付款项。保险公司对于指控多付款项的理由、追回多付款项的方法以及医疗服务提供者上诉该决定的机会往往并不明确。医疗服务提供者可以采用各种策略来有效上诉多付款项的索赔，并且应确保其上诉及时且全面。
