Flagstaff (Ariz.) Medical Center failed to comply with Medicare billing requirements for three of 100 inpatient and outpatient claims reviewed by HHS' Office of Inspector General, according to an OIG report.
For three claims, the hospital incorrectly billed Medicare for inpatient stays that did meet criteria for inpatient status, the OIG said. The three claims that did not comply with Medicare billing requirements resulted in Flagstaff Medical Center receiving $79,216 in overpayments during the two-year audit period of January 2016 through December 2017, according to the OIG.
Based on its findings, the OIG recommended the hospital refund Medicare $79,216, exercise reasonable diligence to identify and return any additional overpayments, and strengthen controls to ensure full compliance with Medicare requirements.
In written comments on the draft report, Flagstaff Medical Center agreed that three claims were improperly billed as inpatient due to human error.