Hospital overpayments due to billing confusion, human errors, OIG finds

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Although West Florida Hospital complied with the majority of inpatient and outpatient claims, the hospital did not fully comply with Medicare billing requirements for 57 claims, resulting in overpayments totaling $173,000 in 2009 and 2010, an audit (.pdf) conducted by the Office of the Inspector General found. OIG officials on Wednesday said that the hospital lacked sufficient controls to prevent incorrect billing and the staff did not fully comprehend billing requirements. The OIG report recommended West Florida Hospital provide training to its staff to avoid confusion regarding billing requirements.

Meanwhile, another OIG audit (.pdf) found that Palmetto General Hospital, also in Florida, generally complied with Medicare billing requirements except for billing errors in 15 claims, resulting in overpayments totaling $125,000 in 2009 and 2010. Most overpayments were a result of human error, according to the report. OIG suggested Palmetto General tighten its controls to better comply with billing requirements.