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What is the process when CGI identifies an underpayment?

April 26, 2017CGI identifies process underpayment

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What is the process when CGI identifies an underpayment?

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CGI reviews claims using automated or complex reviews, to identify potential Medicare underpayments. Upon identification, CGI communicates the underpayment finding to the appropriate MAC/FI/Carrier. Once the appropriate MAC/FI/Carrier has validated the Medicare underpayment, CGI issues a written notice to the provider. The Underpayment Notification Letter includes the claim(s) and beneficiary detail.

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CGI reviews claims using automated or complex reviews, to identify potential Medicare underpayments. Upon identification, CGI communicates the underpayment finding to the appropriate Medicare Administrative Contractor/FI/Carrier. Once the appropriate Medicare Administrative Contractor/FI/Carrier has validated the Medicare underpayment, CGI issues a written notice to the provider. The Underpayment Notification Letter includes the claim(s) and beneficiary detail.