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Audit (A-03-07-00016)

02-12-2009
Review of High-Dollar Payments for Pennsylvania Medicare Part B Claims Processed by Highmark Medicare Services for the Period January 1, 2003, Through December 31, 2005

Executive Summary

Of the 311 sampled payments of $10,000 or more that Highmark Medicare Services (Highmark) made as the carrier for Pennsylvania, 262 were appropriate, and Highmark was reviewing 1 additional payment at the time of our audit. As a result, Highmark overpaid 16 providers $482,000 for 48 payments.

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