ABSTRACT
We will look at some of the underlying issues that generate overpayments. These underlying issues often apply to all types of healthcare providers. The overarching payment compliance issue is, and always has been, medical necessity. After we discuss some of the underlying issues, we will continue with some of the known or already identified issues for different types of healthcare providers. When possible, we will also project into the future to look for potential areas in which overpayments might be asserted. Looking into the future is one of the most difficult tasks for coding, billing, and reimbursement (CBR) compliance personnel. However, if we can identify an issue that will come into focus several years down the road, it is now that we can address changes that will make certain we are in compliance in the future.
