University of North Carolina Hospitals in Chapel Hill, N.C., received at least $2.49 million in overpayments from Medicare from Jan. 1, 2011 to Sept. 30, 2012, according to a recent audit from HHS' Office of Inspector General.
The OIG's $2.49 million-estimation was based on the results of a sample of 251 reviewed claims. Of the 251 inpatient and outpatient claims, 59 of the claims did not fully comply with Medicare's billing requirements, resulting in about $452,000 in net overpayments.
The audit covered $33.1 million in Medicare payments to the hospital for 2,462 claims that were potentially at risk for billing errors. The OIG then selected 251 claims, with payments totaling $3.5 million, as a random sample for review. Based on sample results, the OIG estimated that the hospital received at least $2.49 million in overpayments for the audit period.
The OIG recommended University of North Carolina Hospitals refund the $2.49 million in estimated overpayments to the Medicare contractor and strengthen controls to ensure full billing requirement compliance.
The hospital agreed that 3 of the 59 claims were billed incorrectly, but disagreed with determinations for the remaining 56 claims.
The OIG maintained its findings based on an independent medical review contractor's conclusions.
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