U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of High-Dollar Payments for New Mexico Medicare Part B Claims Processed by Pinnacle Business Solutions, Inc., for the Period January 1, 2003, Through December 31, 2003," (A-06-07-00087)

December 28, 2007

PDF File Complete Text of Report is available in PDF format (266 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


The objective of this review was to determine whether Pinnacle Business Solutions, Inc.ís (Pinnacle), high-dollar Medicare payments to New Mexico Part B providers were appropriate.  Eleven of the 16 high-dollar payments that Pinnacle made to providers were appropriate. However, Pinnacle overpaid providers $39,539 for the remaining five payments.  A provider refunded one overpayment of $1,048 prior to our fieldwork.  Four overpayments totaling $38,491 remained outstanding.  We recommended that Pinnacle recover the $38,491 overpayment and consider using the results of this audit in its provider education activities. Pinnacle agreed with the findings and recommendations.