The $329,054 was based on the results of a sample of 205 reviewed inpatient and outpatient claims. Of the 205 Mercy Hospital claims, 54 of the claims did not fully comply with Medicare’s billing requirements, resulting in overpayments of $329,054.
The OIG recommended Mercy Hospital refund the $329,054 and strengthen controls to ensure full billing requirement compliance.
The hospital agreed with the OIG’s findings associated with 52 of the 54 claims and described corrective actions that it had taken or planned to take to further enhance and strengthen its controls.
The OIG reviewed Mercy Hospital’s comments and maintained its findings.
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