HMA auditors have identified underpayments from Tufts Medicare Preferred (TMP) through our normal client Billing and Payment Review process. We have reached out to multiple client billing companies and they have confirmed that the 2021 TMP payment rates match the incorrect CMS (Medicare) rates that were issued early in December of 2020 but were rescinded shortly thereafter.
The lower CMS rates were formally recalculated and corrected via email by CMS on December 27, 2020 to higher payment rates. TMP did not implement the corrected rates resulting in underpayments varying in degree by CPT code from 3% to 12% lower than the corrected, CMS issued rates.
HMA has notified client billing companies and requested that they reprocess claims in order to pursue the additional revenue to which our clients are entitled.