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 line – Conduct regular audits to identify risk and implement controls – Accountability through Auditing.
- Know your data
- Know your risks
- Audit your risks, outliers and new services
- Implement stop gaps
Learn more about our Revenue Integrity Audit services at firstname.lastname@example.org.