Audit reveals overpayments for inpatient services
Healthcare Auditing Weekly, April 29, 2008
According to an OIG report, TrailBlazer Health Enterprises made 147 high-dollar payments ($200,000 or more) to Medicare Part A providers in calendar year 2003. Eleven of them were overpayments, with 8 of those resulting in net overpayments totaling $50,044. For the other three overpayments, providers agreed that they had submitted incorrect claims and would send revised claims.
The OIG recommended that TrailBlazer
- ensure the recovery of identified overpayments
- follow up with the providers about the three unrevised claims
- use the audit results in its education activities
- consider identification and recovery of additional overpayments made for high-dollar Part A inpatient claims paid after 2003
TrailBlazer stated that providers had adjusted and resubmitted 10 of the 11 claims.
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