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Originally Posted by RoseyRed
Yes I see your point. I do wonder how the audit process did not catch the coding issues mentioned much sooner. Where did all the "extra" money go? Why did TVH not look into why there was so much more money coming in those 4 yrs?
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Because it wasn’t “extra money”. It was just the expected reimbursement from the submitted billing. And (not that I know anything), the external auditors agreed. There was no discrepancy (not that I know anything) until negotiations with Humana uncovered what Humana thought was wrong coding. When this happens, it is best to self report to CMS, and guess which side the federal investigation would fall on??? No need to guess, we all know the answer