Leco Discovers Errors in APG Methodology Payments

July 01, 2011

M. Leco & Associates has uncovered errors in the APG methodology on Medicaid outpatient accounts for hospitals in New York state.

During a managed care review of one its New York clients, Leco's Medicaid experts discovered erroneous underpayments in Ambulatory Surgery, Emergency Department and Clinic/SBHC billings. At this hospital alone, they identified $2.8 million on accounts that had previously been zeroed out, when in actuality, that money rightfully belonged to the hospital.

Leco developed a proprietary software tool to scrub all data for errors, and their Medicaid billing experts examine the outpatient bills and calculate the proper reimbursement for the hospital.

Leco will launch a contingency-based APG recovery service for all New York hospitals later this year.

Since 1982, M. Leco & Associates has provided revenue recovery services, charge process improvement, and outsourced coding for hospitals and health systems nationwide. To date, they have recovered over $1 Billion for their clients.