Saint Francis Health Center, a 253-bed hospital in Topeka, Kan., incorrectly billed Medicare and as a result received millions in overpayments, according to an audit from HHS’ Office of Inspector General.
OIG found that out of a sample of 100 claims, Saint Francis didn’t meet Medicare billing requirements for 51. Extrapolating from the sample, OIG estimated the hospital received $5.5 million in overpayments from 2015-16.
Saint Francis agreed that some of the inpatient claims were incorrectly coded, but didn’t agree with the rest of the OIG’s findings, including the office’s extrapolated overpayment and recommendations.
OIG asked its contractor to review Saint Francis’ comments. The office said additional medical review and evaluation led OIG to change the number of reportable error claims in the audit from an original 53 to 51.
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Source: Becker’s Hospital Review