Try these strategies to get your carrier to pay you what you're due

Why This Topic Matters

Retroactive fee schedule corrections can leave practices underpaid unless discrepancies are found and pursued. Understanding the general workflow for identifying affected claims and communicating with payers can help protect revenue.

Article Sections

1. Detect the problem

   Discusses how practices review payment reports and compare them with fee schedule information to identify possible underpayments. The section focuses on audit approaches and payment variance detection across insurers.

2. Notify your carrier

   Covers the process of informing a payer about a suspected payment discrepancy and documenting the issue for review. It describes the general use of supporting materials and written follow-up.

3. Go to the top

   Describes escalating an unresolved payment issue within the payer organization and continuing documentation of the claim problem. The section also outlines a higher-level follow-up approach after an initial inquiry goes unanswered.

4. Watch for reports of RVU corrections

   Addresses staying alert to published updates that may affect reimbursement and deciding whether pursuing an adjustment is worthwhile. It also discusses assembling claim-related information for follow-up and checking filing procedures with the carrier.

5. Part B News readers had differing experiences with retroactively boosted RVUs

   Summarizes reader survey feedback about whether practices pursued retroactive reimbursement and how difficult the process felt. It provides a brief perspective on reported experiences without detailed methodology.