If a facility submits multiple claims for the same service, resulting in excessive reimbursement, this is termed what?

The situation described involves a facility submitting multiple claims for the same service and receiving excessive reimbursement as a result. This scenario is classified as overpayment. Overpayment occurs when a healthcare provider receives more money than they are entitled to for a service due to billing errors, fraudulent claims, or improper coding. It is a significant concern within healthcare compliance because it can lead to financial losses for payers and may indicate potential fraudulent activity if it is done knowingly.

Understanding overpayment is crucial for compliance practices, as organizations must have effective monitoring systems to identify and rectify such issues promptly. Additionally, the healthcare facility may be required to refund the overpaid amount and could face penalties if the overpayment was due to fraudulent practices.

Therefore, the designation of overpayment accurately reflects the scenario where a facility has submitted more claims than warranted for a single service, leading to excess funds received.