Duplicate Billing of Medicare Services

If you submit more than one claim for the same item or service, you can expect your duplicate claims to be denied. In addition, duplicate claims: 1) may delay payment, 2) could cause you to be identified as an abusive biller, or 3) if a pattern of duplicate billing is identified, may generate an investigation for fraud.

Some providers routinely submit duplicate claims to their Medicare carrier for a single service encounter. Medicare believes that most providers are not deliberately trying to receive duplicate payment by submitting duplicate claims; however, multiple or repetitive billing to Medicare for a particular item or service is improper. CMS has requested providers and suppliers to discontinue this practice.

Once a claim is submitted, providers and suppliers should not resubmit the claim until the claim is paid. One submission is all that is required. If you have not received payment after 30 days and are concerned about your payment, contact your Medicare carrier via its toll-free Customer Service lines to check on claims status or use other electronic claims status inquiry functions to check on claim status. Duplicate billing is costly for any physician medical practice and could be to a physician himself or herself.

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