![\"\"](\"https:\/\/advantagehcconsulting.com\/blog\/wp-content\/uploads\/2018\/04\/Hospice-Cap-gains.jpg\")
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If you\u2019re a hospice provider that\u2019s been hit with an overpayment request from a Recovery Audit or other government contractor, and you\u2019ve exceeded your per beneficiary cap, there may be a small silver lining.<\/p>\n
\u201cIf a hospice is subjected to claim recoveries and has incurred a Medicare cap overpayment … the hospice should request recalculation of cap liabilities subsequent to or simultaneously with the demand for claim recovery,\u201d urges consulting firm\u00a0The Health Group\u00a0<\/strong>in Morgantown, West Virginia. \u201cPayment of claim-related demands may constitute overpaying, in some cases double paying the Medicare program because excess payments were previously determined as part of a cap analysis and repaid to the Medicare program. Denied claims, or claim-related overpayment determinations should be used to reduce payments that were previously used to determine cap liabilities.\u201d<\/p>\n But while \u201cbeneficiary counts may also be reduced as a result of the claim-related denials \u2026 generally the reduction in any beneficiary count is insignificant to the reduction in Medicare payments,\u201d the firm says in its electronic newsletter.<\/p>\n Bottom line:<\/span>\u00a0<\/strong>\u201cMake certain that any claim denials or claim repayments are factored into the determination of cap liabilities,\u201d The Health Group recommends.<\/p>\n Source- SuperCoder<\/span><\/i><\/a><\/p>\n","protected":false},"excerpt":{"rendered":" If you\u2019re a hospice provider that\u2019s been hit with an overpayment request from a Recovery Audit or other government contractor, and you\u2019ve exceeded your per beneficiary cap, there may be … Continue Reading →<\/a><\/p>\n","protected":false},"author":1,"featured_media":143,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[12,10],"class_list":["post-142","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-reimbursement","tag-hospice","tag-hospice-cap"],"_links":{"self":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/142","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/comments?post=142"}],"version-history":[{"count":1,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/142\/revisions"}],"predecessor-version":[{"id":144,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/posts\/142\/revisions\/144"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media\/143"}],"wp:attachment":[{"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/media?parent=142"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/categories?post=142"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/advantagehcconsulting.com\/blog\/wp-json\/wp\/v2\/tags?post=142"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}