- Sent to the wrong provider
- Sent in the wrong amount, underpayment or overpayment
- Sent when proper documentation is not available
- Sent to a fraudulent provider
In the past, CMS has hired contractors to research claims to identify and correct the improper payments by requesting and reviewing medical documentation from the providers. The documentation could be provided by mail or fax.
Now CMS plans to offer a new way to submit the medical documentation. The new method is called esMD or the Electronic Submission of Medical Documentation. For more information about esMD, go to www.cms.gov/esmd/. For more information about improper payments, visit www.paymentaccuracy.gov.
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