The OIG audited Duke’s claims for services between January 2011 and September 2012. Of the 251 sample inpatient and outpatient claims, 72 had billing errors, resulting in net overpayments of $262,884. Most of the errors stemmed from billing inpatient when it should have been billed outpatient and incorrect DRG codes. Based on that sample, the OIG estimated total overpayments during that period topped $626,000.
Duke officials agreed with the OIG’s findings and said it will enhance Medicare billing compliance. Colleen Shannon, Duke’s chief compliance and privacy officer, disagreed with one of the disputed claims that had an incorrect DRG code, but the OIG stood by its findings.
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