News: Billing errors cost Penn. Hospital nearly $2 million

The Office of the Inspector General (OIG) found that Robert Packer Hospital in Sayre, Pa., part of Guthrie Health System, was overpaid $1.876 million, according to a new Medicare compliance review. An audit of nearly 300 claims submitted beween 2009 and 2011 found the hospital did not comply with billing requirements for 99 of them.

Billing for inpatient admissions for outpatient services, assigning incorrect DRG codes, and inappropriately billed evaluation and management services, were among the errors found by the OIG, although disputed by the hospital.

Lucia Saggiomo, Robert Packer’s vice president of internal audit and compliance, emphasized the hospital’s commitment to compliance, stating that “the hospital has implemented a vigorous process to review and confirm the appropriateness of inpatient admissions…, a process that includes the review of certain cases by an independent, nationally recognized physician organization to confirm the appropriateness of inpatient admissions at the time the patient received services at the hospital.”