Retroactive Recoupment: When Payers Claw Back Claims for an Uncredentialed Provider
A new provider starts seeing patients, claims go out, payments come in. Months later, a letter arrives demanding repayment on all of it, because the provider wasn't credentialed when those services were billed. This is retroactive recoupment, and it's one of the most disruptive and preventable things that can happen to a practice's cash flow.