Retrospective Claims Accuracy (RCA) Process Flow
Overpayment Notice
- Cotiviti reviews finalized claims for potential findings.
- Once a claim has been identified as overpaid, Cotiviti may send a written notice of overpayment. The letter contains an explanation of Cotiviti’s findings along with a remittance coupon to complete and return to Cotiviti.
- Complete and return the remittance coupon to Cotiviti within 45 days.
Cotiviti Overpayment Notice Par Sample.pdf *
Agree with Overpayment Findings: Circle "Yes" on the remittance coupon
Participating providers:
1. Return the Remittance Coupon to Cotiviti
Cotiviti, Inc.
Attn: Claims Review – HC BCBSND Correspondence Team
Hillcrest Building
731 Arbor Way, Suite 150
Blue Bell, PA 19422
2. The claim will be adjusted to deny and you will receive a notification on your electronic remittance advice within 45 days.
Disagree With Overpayment Findings: Circle "No" on the Remittance Coupon and Return to Cotiviti
Include rationale, coding changes and supporting documentation. (DO NOT SUBMIT A CLAIM CORRECTION)
Cotiviti, Inc.
Attn: Claims Review—HC BCBSND Correspondence Team
Hillcrest Building
731 Arbor Way, Suite 150
Blue Bell, PA 19422
Note: If a reconsideration is not requested within 45 days, reconsideration rights are forfeited. The claim will be adjusted to deny, and you will receive notification on your electronic remittance advice within 45 days.
For questions on your overpayment notice, please call Cotiviti at 203-529-4199.
Coding changes must be requested during the reconsideration process. Requests received outside of the reconsideration process will be rejected.