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Sequence of Recoupment

Introduction and Background

On October 4, 2021, the Maryland Department of Health (MDH) announced it would begin the process of recouping overpayments made to providers through the Optum Behavioral Health Administrative Services Organization (BHASO) during the “estimated payment” period of January 1, 2020 through August 3, 2020. During this period, MDH directed Optum to make estimated payments to providers based on their average monthly claims payments in 2019 due to issues with processing and paying claims through the BHASO platform. 

Next Steps

MDH and Optum understand the challenges that many providers experienced while using the BHASO platform and have been working closely to establish an estimated payment recoupment process that is as fair and flexible as possible. For the latest details regarding the recoupment of overpayments, please view the provider transmittal "Extension of Overpayments Reconciliation" dated October 2, 2023.

Providers who are eligible for the six-month extension of recoupment of estimated payments have received a letter and survey link delivered to their Incedo "Download" Folder. Providers can use this survey to advice Optum and MDH of their repayment preference. Please look in the Incedo "Download" folder for the filename beginning "EPExtensionSurvey" and complete this survey by end of day on November 10, 2023.

Assistance

For assistance with reconciliation at any time, we encourage providers to engage with an Optum Reconciliation Manager by sending an email to maryland.provpymt@optum.com. Please visit maryland.optum.com for provider resources, online training, and more information.