- ABN Modifiers
- American Medical Association and Current Procedural Terminology
- CMS Forms and Publications
- CMS Regional Offices
- Clinical Lab Improvement Amendment
- Comprehensive Error Rate Testing
- Electronic Health Records
- Electronic Prescribing
- Evaluation and Management Documentation Guidelines
- Federal Register
- Health Insurance Portability and Accountability Act of 1996
- Interactive Voice Response System
- Limitation of Liability (Advance Beneficiary Notice of Noncoverage)
- Local Coverage Determination
- Medically Unlikely Edits
- Medicare Coverage Database
- Medicare Electronic Data Interchange
- Medicare Fraud and Abuse
- Medicare Learning Network®
- Medicare Provider-Supplier Enrollment with NGS
- NGS Internet Resources
- NGSConnex Online Web Application Can Save Time and Money
- NGS Check Provider Enrollment Application Status Tool
- National Correct Coding Initiative
- National Coverage Determination
- National ICD-10-CM-PCS: The Next Generation of Coding
- National Provider Calls and Events
- National Provider Identifier
- National Provider Identifier Registry
- National Uniform Claim Committee
- Open Door Forums
- P.O. Box Mailing Addresses
- Patient Protection and Affordable Care Act of 2010
- Physician Quality Payment Program
- Provider Contact Center
- Provider Enrollment
- Reconsideration (Second Level of Appeal)
- Recovery Audit Program
- Redetermination (First Level of Appeal)
- Skilled Nursing Facility Consolidated Billing
- U.S. Government Printing Office
- Washington Publishing Company
Recovery Audit Program
The Recovery Audit Program’s mission is to identify and correct Medicare improper payments through the efficient detection and collection of overpayments made on claims of health care services provided to Medicare beneficiaries, and the identification of underpayments to providers so that the CMS can implement actions that will prevent future improper payments nationwide.
The CMS has retained Performant Recovery, Inc. to carry out the Recovery Audit Program for Region 1 and Region 2. These programs are mandated by Congress aimed at identifying Medicare improper payments and will assist CMS by working with providers in reducing Medicare improper payments through the efficient detection and recovery of overpayments, the identification and reimbursement of underpayments and the implementation of actions that will prevent future improper payments.
When the RA finds that improper payments have made been, the RA will submit claim adjustments to NGS, NGS will then establish an account receivables, which will issue automated demand letters for any recoveries the auditor identified as overpayment(s). NGS will then follow the same process as is used to recover any other payment.
Visit our Recovery Audit web page for contact information.
Reviewed 10/13/2023