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Audit (A-04-07-06022)

10-1-2008
Review of High-Dollar Payments for Inpatient Services Processed by Palmetto GBA, Intermediary #380, for the Period January 1, 2004, Through December 31, 2005

Executive Summary

During calendar years 2004-2005, Palmetto GBA (Palmetto) overpaid nine claims totaling $111,000. Generally, Palmetto made the overpayments because the providers incorrectly billed excessive units of service. In written comments on our draft report, Palmetto agreed to recover the $111,000 in overpayments and adjust the claims. Palmetto stated that it would use the results of this audit to enhance its provider education activities and agreed to implement controls to identify and review all payments greater than $200,000 for inpatient services.

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