Current Status

12/14/2018 Resolved: All adjustments have been completed.

Issue Identified by Cahaba: June 20, 2017 – Jurisdiction J Carry-Over Issue
Issue: Cahaba made Palmetto GBA aware that some claims incorrectly continued to be paid after a provider’s Medicare PTAN deactivation/revocation date.

Provider Action:
There is no provider action for this issue until a provider receives an overpayment demand letter at which time providers should timely refund the requested money as outlined in their overpayment letter. The preferred method of refunding overpayments is through the eCheck or eOffset features available in the Palmetto GBA eServices portal. Providers may sign up below for automatic notification of updates to this CPIL.

Status:

12/14/2018 Resolved: All adjustments have been completed.

9/13/2018: Palmetto GBA has initiated adjustments to recover payments associated with dates of services after a provider’s PTAN deactivation date.

Overpayments associated with this issue will appear on the provider remittance advice with Remittance Advice Remark code N570 (Missing/incomplete/invalid credentialing data.). Providers should timely refund the requested money as outlined in their overpayment letter.

We have identified a small number of instances where the PTAN may have been incorrectly deactivated by the previous Medicare Administrator (MAC). If you believe the overpayment was established in error due to an incorrectly deactivated PTAN, please submit a timely appeal to stop recoupment. To assist with expediting the processing of your appeal and the resolution of the issue, please provide any additional PTANs that were established for the billing NPI. Each instance brought to our attention will be researched individually and we will respond to each request. Research will include validating the original deactivation action. 

6/26/2018: Adjustments have been made for 2015 dates of service. 

 

 

 

6/11/2018: Claims with 2018, 2017, and 2016 dates of service have been adjusted. Affected providers will receive overpayment letters. Palmetto GBA continues to research older dates of service for any necessary action.

2/26/2018: On February 1, 2018, Cahaba notified providers and Palmetto GBA that this issue would be addressed by Palmetto GBA after the Jurisdiction J transition. Palmetto GBA is in the process of identifying the affected claims at which time, overpayment demand letters will be sent to the affected providers.

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



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