Recoupments are one of the least-visible threats to an ASCs margin. They surface as offsets and provider-level balance adjustments months, sometimes years, after the money was already counted as collected.
For surgery centers running lean billing teams, that timing is the whole problem. Medicare’s Recovery Audit Contractors can look back three years from the date a claim was paid, which means revenue you booked in 2023 can still be pulled back today.
Leaders from SCA Health, Cleveland Clinic and Erlanger Health System sat down to talk candidly about why recoupments are so easy to miss and so hard to unwind and why the denial playbook most teams rely on doesn’t fit a problem that lands after payment.
This report breaks down what they discussed, including:
- Why recoupments slip past standard denial workflows
- Where post-payment revenue quietly erodes before anyone notices
- The signals that a takeback is coming
- How high-volume teams are getting ahead of the next audit