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Medicare Secondary Payer

Overpayments generally result when payment is made by Medicare for noncovered items or services, when payment is made that exceeds the amount allowed by Medicare for an item or service, or when payment is made for items or services that should have been paid by another insurer (Medicare secondary payer obligations). Once a determination and any necessary adjustments in the amount of the overpayment have been made, the remaining amount is a debt owed to the United States Government Questions to ask include, is the provider inappropriately billing Medicare first, when Medicare payments for such beneficiaries are required to be secondary to certain types of private insurance coverage. How does the provider resolve credit balance situations?

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