When a Medicare Administrative Contractor (MAC) adjusts a claim, one of the potential outcomes is that the contractor recognizes an overpayment that has been made to the provider. In this case, the MAC will issue a demand letter to the provider detailing the overpayment and outlining the process for recovering those funds. This is a formal notification that indicates the provider is required to return the excess payment to Medicare.
The process serves as part of the MAC's responsibility to ensure that payments are accurate and compliant with Medicare regulations. By sending a demand letter, the MAC is taking the necessary steps for financial accountability while maintaining the integrity of the Medicare program.
While the other choices could refer to different actions that a MAC might take under various circumstances, they do not specifically describe the procedure that follows an adjustment due to an overpayment. Thus, the issuance of a demand letter accurately reflects the actions of a MAC concerning claim adjustments when it pertains to overpayments.