The $267,000 was based on the results of a sample of 213 reviewed claims. Of the 213 inpatient and outpatient St. Vincent claims, 22 of the claims did not fully comply with Medicare’s billing requirements, resulting in $267,000 in overpayments.
The OIG recommended St. Vincent refund the $267,000 and strengthen controls to ensure full billing requirement compliance.
Although the hospital did not contest audit findings with respect to 13 outpatient claims and four inpatient claims, it did “strongly disagree” with the findings in regard to the clinical merits of five inpatient claims.
The OIG reviewed St. Vincent’s claims and maintained their findings.
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