This is an important update for hospitals working to recover Transfer DRG underpayments.
- The OIG is currently auditing accounts impacted by the Transfer Rule that have a discharge status 01 or other status indicating no transfer. This specific audit by the OIG includes claims from 2016 – 2018.
- The OIG is providing their findings to the MACs with instructions to collect overpayments from providers in their regions. MACs will reject these claims forcing takebacks.
- CMS is estimating this effort will yield approximately $250 million in overpayments.
What you can do:
As this item remains open on the OIG workplan, several providers have opted to have BESLER conduct an overpayment review. In short, we will run your claims through the same validation steps we employ for underpayment review, but with the purpose of identifying potential overpayments. We will only call on accounts that show a potential transfer resulting in a nominal fee per call.
If you would like to find out more about this review, please contact us at firstname.lastname@example.org.
Listen to our podcast for more information about Medicare overpayments.