OIG tags Illinois hospital for erroneous billing

After reviewing the hospitals comments, the OIG preserved its findings and recommendations..

St. Francis Healthcare Facility in Peoria, Ill., failed to abide by Medicare billing requirements for 14 of 100 inpatient and outpatient claims reviewed by HHS Office of Inspector General, according to an OIG report..

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Based on its findings, the OIG suggested the health center refund Medicare $1.6 million in approximated overpayments, workout reasonable diligence to recognize and return any extra overpayments and strengthen controls to ensure complete compliance with Medicare requirements..

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The 11 inpatient claims and three outpatient declares that had billing mistakes led to the healthcare facility getting $204,265 in overpayments during the audit period of Jan. 1, 2016, through Dec. 31, 2017, according to the OIG..

In written discuss the draft report, the hospital disagreed with most of the OIGs findings and suggestions, including the OIGs projection method. The health center agreed with six of the 14 billing errors recognized in the sample..

Theorizing from the sample results, the OIG approximated St. Francis Hospital received $1.6 million in overpayments from Medicare throughout the audit period..