Medicare_Carriers_Manual / 7153 / 7153

Why This Topic Matters

Understanding the distinction between sampling and individual claim review can affect how overpayments are identified, how claims are reexamined, and how post-payment review activities are planned.

Article Sections

1. Ed. Note: For further information see:

   A short editorial note pointing readers to related material about carrier tools and overpayment spotting.

2. 7153. Sampling No Substitute for Case-by-Case Review

   Guidance on post-review methodology for claims, including discussion of when broader review approaches may be considered and the importance of reviewing claims individually in some situations.