WASHINGTON -- The private companies that process health claims for Medicare made nearly $20 billion in erroneous or questionable payments last year, an error rate of 9.3 percent, the government said Monday. The performance was a slight improvement over last year.
The error rate measures claims that were paid despite being medically unnecessary, inadequately documented or improperly coded. In some instances, Medicare asked health care providers for medical records to back up their claims and got no response.
Medicare chief Mark McClellan said the survey does not document instances of alleged fraud.
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The review found that doctors and other providers were paid $900 million less than they should have received because of errors made by insurers. By contrast, there were $20.8 billion in questionable overpayments, Medicare said.
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