Audit and Reimbursement
Published 03/13/2023
Medicare Audit and Reimbursement is divided into three distinct areas: reimbursement, audit and cost reports. The primary functions of the Medicare Audit and Reimbursement unit is:
- Assure final payments to providers are in accordance with Medicare laws, regulations and instructions
- Verify financial and statistical information contained in the Medicare cost report
- Arrive at a correct program reimbursement. In so doing, preserve the provider's interests and rights but at the same time apply program policies to specific situations to ensure compliance with these policies.
Audit and Reimbursement Contact Information
- For interim rate review, provider-based determinations and other reimbursement documentation — JMREIMBURSEMENT@palmettogba.com
- For reopening requests and related documentation — JMAUDIT.REOPENING@palmettogba.com
- For appeal requests and related documentation — JMAUDIT.APPEAL@palmettogba.com
- For wage index and occupational mix documentation — COSTREPORT.WAGEINDEX@palmettogba.com
- For general desk review and audit questions — JMCOSTREPORT@palmettogba.com
- For Volume Decrease Adjustment (VDA) payment requests or questions — JMAUDIT.REOPENING@palmettogba.com
- For cost report filing documentation or questions — STAR@palmettogba.com
- For Provider Statistical and Reimbursement (PSR) requests — STAR@palmettogba.com
- Use the Cost Report Status Tool to check the receipt and acceptance decision for a recently submitted cost report
- For general information, contact the Provider Contact Center (PCC) at 855–696–0705
Resource: RHC Productivity Standard Exceptions.