Responding to an insurer's recoupment of past payments.

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.