In its report, the office reviewed claims paid to hospitals from the National Government Services, a contractor for Medicare providers.
The office found that National Government Services incorrectly paid hospitals for nearly all the Medicare beneficiaries it reviewed.. While most of the radiation therapy services billed by hospitals were allowable, National Government Services made overpayments for at least one service for 99 of the 100 beneficiaries in its random sample.
Overpayments occurred because system edits didn’t prevent NGS from paying hospitals for incorrectly billed radiation services and “hospitals were unfamiliar with, or misinterpreted Medicare guidance when billing for IMRT services, or cited clerical errors,” the federal report states.
The office recommended three ways for National Government Services to recover overpayments and made two procedural recommendations for properly billing for radiation services.
More articles on healthcare finance:
Major health systems, insurers have converted nearly half of business to value-based payments
RCM tip of the day: Introduce appreciative inquiry
94% of patients expect their provider to tell them about bill payment options, survey finds
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.