After conducting an analysis on a large employer, researchers also found that more than half of the duplicate claims filed received payment; one-third of the duplicate claims filed were paid more than what was billed; and the employer paid more than $100,000 in overpayments on duplicate claims.
"There is an occurrence of duplicate billing on the exact same workers' comp claim, same date of service, same ICD-9, same billing codes, same provider also billing to group health," said Archie Anderson, president of OCI. "This was an aged claim analysis, meaning all the payments have been made. This particular employer was not even aware."
OCI said to prevent this, an employer must commit to integrating its workers' comp, health care billing and claims data to identify where the duplicate billing and payments occur.
July 26, 2010
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