Review of High-Dollar Part B Claims Processed by Cahaba Government Benefits Administrators Carrier No. 00511 for the Period January 1, 2004, Through December 31, 2006

During calendar years 2004'2006, Cahaba Government Benefit Administrators Carrier No. 00511 (the contractor) overpaid providers in Georgia $138,000.  Generally, the contractor made the overpayments because the providers incorrectly billed excessive units of service.  In addition, the Medicare claims processing systems did not have sufficient edits in place during calendar years 2004'2006 to detect and prevent payments for these types of erroneous claims.  We recommend that the contractor recover the identified overpayments.  The contractor agreed our recommendations.