In the latest twist of the ongoing saga of Medicare claims denials and appeals, the U.S. District Court for the District of Columbia ordered Medicare must clear its backlog, which currently approaches one million claims,...Read More »
Every year the Office of the Inspector General (OIG) publishes a list of its audit targets for the following calendar year. Although this hefty tome tops 100 pages, it’s worth a review to ensure the OIG’s targets aren’t diagnoses and documentation trouble spots at your facility.Read More »
Physicians often ask why documentation matters to them. Last week, CMS sent out a reminder regarding the importance of complete and accurate documentation related to physician evaluation and management (E/M) codes.Read More »
$14.2 million. That’s what Medicare paid New York-Presbyterian Hospital in overpayments for 123 claims because the hospital did not have “adequate controls to prevent the incorrect billing of Medicare claims,” according to the Office of the Inspector General (OIG).Read More »
The Office of the Inspector General (OIG) continues to target fraudulent Kwashiorkor claims. This time, the agency found Cornerstone Hospital of Bossier City, Louisiana, was overpaid $321,971 for inpatient claims. OIG audited 73 of the 189 claims with Kwashiorkor submitted by the 62-bed long-...Read More »
Recent investigations by the Office of Inspector General (OIG) have shown a number of instances in which hospices inappropriately billed Medicare for hospice general inpatient care (GIP), according to a statement released by the OIG.Read More »
Even though Promise Hospital of Ascension, a 54-bed transitional care hospital located in Gonzales, Louisiana, closed before the Office of the Inspector General (OIG) began auditing it for fraudulent Kwashiorkor claims, the agency found errors resulting in more than $450,000 in overpayments. In...Read More »
