Ambulatory Surgery Centers See Medicaid Recoupment

NCTracks has issued a notice to 34 Ambulatory Surgery Centers (ASC) throughout the state that a claims reprocess for non-covered services will be taking place in the June 6 check write to recoup any overpayments.  The claims that are affected were originally processed and paid between July 2, 2013 and August 9, 2016 and included codes that are non-billable per the Centers for Medicare and Medicaid Services (CMS).  The specific codes and respective end dates can be seen here and were included in the September 2016 Medicaid Bulletin. The North Carolina Division of Medical Assistance (DMA) also issued a special May 2017 Medicaid Bulletin with more information on the recoupment.

Once NCTracks became aware of the overpayments, they changed the system to remove the non-billable codes in August 2016 for all subsequent payments, but previous overpayments were not recouped at that time. Those overpayments will be retrieved in the upcoming checkwrite on Tuesday.

 
 

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