Earlier this month, a hospital in Miami was hit with a $3.7 million bill from the Department of Health and Human Services, claiming that it overbilled inpatients for a period of time ranging from April 1, 2009 through December 31, 2010. An investigation from the Office of the Inspector General (OIG) found that there was likely no malfeasance at play and rather the billing and accounts receivable office made mistakes due to poor financial, coding and management controls.
"Overpayments occurred primarily because the hospital did not have adequate controls to prevent incorrect billing of Medicare claims within the selected risk areas that contained errors,'' the OIG report states.
The hospital is expected to pay the money, which will go to those who were overbilled during the noted timeframe, but the OIG also has asked the hospital to improve its controls as part of an effort to prevent such mistakes from happening again.
While the hospital does admit to many of these claims, it has questioned the amount listed on their bill, claiming the overcharges were not so egregious. According to the Miami Herald, the hospital is working with the government to determine just how much it owes.
Much like the initial problem, the issue of determining the exact amount the hospital owes could have been assisted with the right management service in the billing and accounts receivable department. If organizations lack the right controls or adequate personnel to manage these processes, these types of incidents could persist. Working with a third party organization that can help manage all of your billing and accounts receivable needs can go a long way toward mitigating the potential for these types of problems.