North Carolina Hospitals Receiving Outlier Payment in Error

 Current Status
11/21/2019: The mass adjustment of impacted North Carolina acute hospital claims will be completed by December 31, 2019.

Issue Identified: November 5, 2019

Issue
Palmetto GBA identified an issue with North Carolina hospitals receiving outlier payments in error due to a system issue regarding the cost to charge ratio. Inpatient claims with dates of service October 1, 2019, and after were affected.

Provider Action
There is no provider action required. Palmetto GBA will adjust all affected claims by November 29, 2019.

Status History
11/5/2019: Palmetto GBA identified an issue with North Carolina hospitals receiving outlier payments in error due to a system issue regarding the cost to charge ratio. Inpatient claims with dates of service October 1, 2019, and after were affected.

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