Submitting OIG:
Report Description:
Christian Hospital (the Hospital) (operating in Saint Louis, Missouri) complied with Medicare billing requirements for 95 of the 199 outpatient and inpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 104 claims, resulting in overpayments of $341,000 for calendar years 2012 and 2013. Specifically, 89 outpatient claims had billing errors, resulting in overpayments of almost $280,000, and 15 inpatient claims had billing errors, resulting in net overpayments of almost $62,000. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.
Date Issued:
Tuesday, July 5, 2016
Agency Reviewed / Investigated:
Submitting OIG-Specific Report Number:
A-07-15-05075
Component, if applicable:
Centers for Medicare & Medicaid Services
External entity, if applicable:
Christian Hospital
Location(s):
MO
United StatesType of Report:
Audit
Questioned Costs:
$341,221
Funds for Better Use:
$0
Number of Recommendations:
2
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