"Review of High-Dollar Payments for Louisiana Medicare Part B Claims Processed by Pinnacle Business Solutions, Inc., for the Period January 1, 2003, Through December 31, 2003," (A-06-07-00085)

Department of Health and Human Services

Office of Inspector General -- AUDIT

"Review of High-Dollar Payments for Louisiana Medicare Part B Claims Processed by Pinnacle Business Solutions, Inc., for the Period January 1, 2003, Through December 31, 2003," (A-06-07-00085)

December 28, 2007

Complete Text of Report is available in PDF format (286 kb). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.

EXECUTIVE SUMMARY:

The objective of this review was to determine whether Pinnacle Business Solutions, Inc.’s (Pinnacle) high-dollar Medicare payments to Louisiana Part B providers were appropriate. Twenty-nine of the thirty high-dollar payments that Pinnacle made to providers were appropriate. However, Pinnacle overpaid one provider $19,641 for the remaining payment. We recommended that Pinnacle recover the $19,641 overpayment and consider using the results of this audit in its provider education activities. Pinnacle agreed with the finding and recommendations.