For its audit, the inspector general reviewed a sample of 100 claims with payments that totaled $1.4 million. The audit period ran from January 2016 through December 2017.
While Edward W. Sparrow Hospital complied with Medicare billing requirements for 91 of the 100 inpatient and outpatient claims reviewed, the remaining nine claims had inaccuracies that led to the overpayments. The office estimates those overpayments totaled $550,917 based on the sample results.
The inspector general said the errors happened because the hospital didn’t have adequate controls in place to prevent the incorrect billing. The hospital disagreed with the office’s findings and plans to appeal.
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