A federal review has found Cleveland Clinic was overpaid approximately $254,000 for 24 Medicare claims from 2008-2009, according to a report from the Office of Inspector General.
The report says Cleveland Clinic did not fully comply with Medicare requirements to obtain credits available from manufacturers. Credits pertain to medical device replacements. When a device needs to be replaced, providers may receive full or partial credit from the manufacturers of devices that are covered under warranty or replaced because of recalls.
To offset these credits, Medicare can reduce the payment for a replacement device if the provider receives full credit for the replacement cost or partial credit equal to or greater than half the cost of the replacement.
For 24 processed claims, credits were available from device manufacturers, but Cleveland Clinic either did not obtain them or did not report them. This resulted in overpayments of $184,568 for outpatient services and $69,025 for inpatient services.
The OIG has recommended Cleveland Clinic adjust the erroneous claims, resubmit them and strengthen procedures for obtaining and reporting credits.
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The report says Cleveland Clinic did not fully comply with Medicare requirements to obtain credits available from manufacturers. Credits pertain to medical device replacements. When a device needs to be replaced, providers may receive full or partial credit from the manufacturers of devices that are covered under warranty or replaced because of recalls.
To offset these credits, Medicare can reduce the payment for a replacement device if the provider receives full credit for the replacement cost or partial credit equal to or greater than half the cost of the replacement.
For 24 processed claims, credits were available from device manufacturers, but Cleveland Clinic either did not obtain them or did not report them. This resulted in overpayments of $184,568 for outpatient services and $69,025 for inpatient services.
The OIG has recommended Cleveland Clinic adjust the erroneous claims, resubmit them and strengthen procedures for obtaining and reporting credits.
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