Gov’t audit insider: Coding transfers as discharges
Healthcare Auditing Weekly, June 8, 2004
If your billing and coding department isn't correctly capturing transfers, you could end up juggling an OIG audit. More than 100 hospitals in North Carolina illegally received some $3 million in overpayments for billing transfers incorrectly as discharges, according to an audit report the OIG released May 17.
To identify patients transferred, but billed as discharges, the OIG performed the following tasks:
- Examined standards and methodology behind inpatient payment rates
- Established a routine process for detecting incorrectly paid transfers
- Pinpointed actual incorrect claims after analysis of all potentially flawed claims
- Used medical records to confirm that a transfer had taken place
North Carolina is expected to collect the millions of dollars in overpayments to refund state and federal monies, the OIG says.
Click here to read the audit report called "Audit of Hospital patient transfers paid as discharges and claimed under the North Carolina Medicaid program."
Need help on how to avoid problems like these? let us know: Send an e-mail to Bryan Cote at bcote@hcpro.com. Please write "OIG audit" in the subject line, and provide contact information.
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