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. 

Repayment of estimated payment balances is due to be completed on June 30, 2024. Providers who are expected to have an outstanding amount (or"balloon payment") due on June 30, must complete this survey by end of day on May 10, 2024, to advise Optum Maryland and the Maryland Department of Health of their prefered method of managing this balance. 

A memorandum from the Secretary regarding estimated payment balances and completion of this survey was released on April 26, 2024. 

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.