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DEPARTMENT OF HEALTH SERVICES Office of the Inspector General F02296C (02/2020) STATE OF WISCONSIN Wis. Stat. 49.45(2) OVERPAYMENT RECOVERY The Office of the Inspector General (OIG) has reviewed allegations
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Claims overpayments refer to the excess payments made by insurers or payers for healthcare services that were not fully justified by the documentation or coding submitted by healthcare providers.
Healthcare providers, organizations, and billing entities that have received overpayments from insurers or government payers are required to file claims overpayments.
To fill out claims overpayments, provide necessary details such as patient information, service dates, the amount of overpayment, reason for the overpayment, and any additional documentation required by the payer.
The purpose of claims overpayments is to report and reconcile excess funds received, ensuring compliance with billing practices and preventing future payment discrepancies.
The information that must be reported includes patient identification, the total amount of the overpayment, service codes, dates of service, and explanatory notes pertaining to the overpayment.
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