Section R414-24-4 - Self-Audited Claims(1) Providers must identify and report any overpayments within three years of the service date. Accordingly, providers or their contractors must complete self-audits of claims and submit claim corrections within three years of the service end date.(2) Providers are responsible for their claim adjustments. Providers must attempt to make adjustments on their own before requesting Medicaid staff to make claim corrections. If a claim is in a suspended status, Medicaid will assign a worker to process the claim according to the policy for the edit.(3) Providers identifying overpayments beyond the deadline noted in Subsection (1) must contact the Office of the Inspector General of Medicaid Services to resolve the overpayment.Utah Admin. Code R414-24-4
Adopted by Utah State Bulletin Number 2023-08, effective 4/3/2023