OIG Audit Adjustment Process

OIG Audit Adjustment Process
Current Status
Date
 
Update
October 15, 2020
Status:
History-only claim adjustments were completed August 25, 2020. No overpayments have been demanded or collected for these adjustments at this time. Palmetto GBA is currently reconciling calculated overpayments to verify accuracy prior to issuing demand letters. We anticipate issuing validated overpayment demand letters by October 30, 2020.
Reopened
June 9, 2020
Status:
Palmetto will reprocess the original OIG adjustment related to A-09-19-03007 to update the patient discharge status.  This adjustment will result in a partial reimbursement and establish an overpayment due from the provider. After completion of the adjustment, the provider will receive a demand letter from the MAC for this overpayment. 
OIG adjustments for PIP providers will appear on your remittance advices; however, you will not receive demand letters related to these adjustments.

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