A federal audit has found St. John's Hospital in Springfield and Joplin, Mo., did not fully comply with Medicare billing requirements for selected inpatient and outpatient claims, according to a report from the Department of Health and Human Services Office of the Inspector General.
Of 224 sample claims, 58 had errors that resulted in net overpayments totaling $420,410 from 2008-2010. The report says the errors occurred primarily because the 866-bed hospital lacked the "adequate controls to prevent incorrect billing" and did not fully understand billing requirements.
The government has recommended the hospital refund $420,410 to Medicare and strengthen controls to ensure full compliance with Medicare requirements.
The hospital responded to the government, concurring with its findings but indicating that overall net recovery would be lower after it worked with the Medicare contractor to re-bill eligible claims.
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Of 224 sample claims, 58 had errors that resulted in net overpayments totaling $420,410 from 2008-2010. The report says the errors occurred primarily because the 866-bed hospital lacked the "adequate controls to prevent incorrect billing" and did not fully understand billing requirements.
The government has recommended the hospital refund $420,410 to Medicare and strengthen controls to ensure full compliance with Medicare requirements.
The hospital responded to the government, concurring with its findings but indicating that overall net recovery would be lower after it worked with the Medicare contractor to re-bill eligible claims.
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