Should a carrier calculate underpayment penalties to a provider by using the particular services on the claim that were underpaid?
Neither the statute nor the rules explicitly state that calculations of underpayment penalties should be performed on a line item basis. However, TDI has consistently maintained in the past that line item calculations are appropriate and that penalty calculations should not include services that were correctly and timely paid.
Related Questions
- Should a carrier calculate underpayment penalties to a provider by using the particular services on the claim that were underpaid?
- Do my employees need to submit a claim to BCBSWY after receiving healthcare services or will the provider handle it?
- How long does a provider have to submit a bill/claim for delivered services?
