NHIC makes inappropriate payments for outpatient laboratory services
Compliance Monitor, November 29, 2007
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
The OIG found that the National Heritage Insurance Company (NHIC) made inappropriate Part B payments for outpatient laboratory services received by Medicare beneficiaries during inpatient stays at prospective payment system hospitals in 2005. NHIC paid laboratory suppliers $292,524 for laboratory services.
The OIG recommended NHIC:
- Recover $13,101 in overpayments for the sampled services
- Reemphasize to laboratory suppliers the need for internal control systems to prevent improper billing
- Adjust its existing prepayment edits to identify and deny payments for laboratory services billed with the inpatient hospital place of service code.
NHIC agreed with the OIG's findings and recommendations.
To read more click here
Want to receive articles like this one in your inbox? Subscribe to Compliance Monitor!
Related Products
-
Strategies for Health Care Compliance
News and real-life examples to increase the effectiveness of your compliance program. Strategies for Health Care Compliance...
-
Compliance Monitor
This HTML e-mail newsletter delivers news on Medicare and Medicaid fraud and abuse, as well as recent documents and targets...
-
Medicare Weekly Update
Each issue of Medicare Weekly Update includes the latest CMS proposed and final rules, CMS manual revisions, and...
-
Medicare Update for Physician Services
Medicare Update for Physician Services is a free, monthly e-zine that delivers news and information to help physician...
Most Popular
- Articles
-
- HIPAA Q&A: Level of encryption needed for email
- Q/A: Volume requirement for reporting hydration services
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- Catch up on what's new with injections and infusions
- Identify potential Medicaid RAC target areas
- Capturing all necessary codes for IUD insertion and removal can be challenging
- Topic: CMS, OESS post new security compliance review information, checklist
- What does case-mix index mean to you?
- Q&A: Acute respiratory failure diagnosis does not require intubation
- OB services: Coding inside and outside of the package
- E-mailed
-
- Q/A: Volume requirement for reporting hydration services
- HIPAA Q&A: Level of encryption needed for email
- Featured blog post: Nurses face felony charges after reporting physician to the Texas Medical Board
- CMS has reformulated payments for some bilateral procedures
- Oxygen Cylinder Storage Requirements
- Q&A: Acute respiratory failure diagnosis does not require intubation
- Q&A: Follow CMS' coding guidelines when using modifier -25
- Understand the spine to code back procedures correctly
- Catch up on what's new with injections and infusions
- Hospitals are not bound by InterQual criteria for determining patient status
- Searched