Accountability through Auditing

Recently, the government determined that a North Carolina hospital failed to comply with Medicare billing requirements for 29% of the cases reviewed in the sample.  Using extrapolation, the government is requesting the hospital repay over $700,000 in overpayments.  In addition to the repayment, the government included other mitigation strategies that hospital organizations should pay attention to:

  • Exercise diligence in identifying and returning any additional overpayments outside of the audit period
  • Strengthen controls to ensure compliance with billing requirements

Punch lineConduct regular audits to identify risk and implement controls – Accountability through Auditing.

  • Know your data
  • Know your risks
  • Audit your risks, outliers and new services
  • Educate
  • Implement stop gaps

Learn more about our Revenue Integrity Audit services at contact@providentedge.com.

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