News: OIG finds PacifiCare received more than $100 million in overpayments
CDI Strategies, August 2, 2012
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A recent Office of the Inspector General report found PacifiCare of Texas received $115 million in CMS overpayments. The OIG reviewed 100 sample cases and found 43 claims with incorrect payments. According to the report, PacifiCare, which administers healthcare plans for approximately 118,000 beneficiaries, submitted diagnosis codes which were not supported by physician documentation.
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