Meritus Medical Center Refunded Overpayments for Physician Claims with Place-of-Service Coding Errors for 2009 Through 2012.

摘要

Prior nationwide reviews found that Medicare contractors overpaid physicians who did not correctly identify the place of service on their claims. These audits identified over a million nonfacility-coded physician services that matched outpatient hospital claims for the same type of service provided to the same beneficiary on the same day. One review identified instances of overpayments to Meritus Medical Center (the Hospital) because it submitted incorrectly coded nonfacility place-of-service claims for services provided in its wound care facility by its employed physicians. The Hospital also submitted claims for the facility overhead expense of many of these medical services. Hospital officials performed a self-audit after receiving our initial inquiry and voluntarily refunded all place-of-service coding overpayments. The Hospital requested that the Office of Inspector General verify the accuracy of the overpayment amount that it refunded to its Medicare contractor. The objective of this review was to verify the amount of overpayments for physician claims with place-of-service coding errors submitted by the Hospital to its Medicare contractor for calendar years (CY) 2009 through 2012.