OIG: Mutual of Omaha must recover $4,109
Compliance Monitor, January 4, 2006
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The OIG has recommended that Mutual of Omaha recover $4,109 in overpayments related to inproper claims for outpatient stent placements. The OIG audited 28 paid Medicare claims processed by Mutual of Omaha in Texas to determine whether services provided in 2002 were
The OIG found that two claims from two providers were overpaid a total of $4,109. The errors may have occurred because the providers did not have procedures in place to ensure that the services met Medicare requirements, according to the OIG.
The OIG further recommended that the insurance company provide education to the two errant providers to ensure that the claims they submit for reimbursement meet Medicare's requirements. Mutual generally agreed with findings and recommendations, but did not agree that one of the Healthcare Common Procedure Codes in question should be denied.
To complete the audit, the OIG
Click here to read the audit report, "Review of the Services Related to the Placement of Arterial Stents," (A-06-04-00092) issued December 9, 2005.
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