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Audit (A-01-11-00512)

09-29-2011
Verification of Saint Francis Medical Center's Refund of Place-of-Service Overpayments for Calendar Years 2009 Through 2010

Executive Summary

We determined that Saint Francis Medical Center (the Hospital) and two independent physicians who performed services at the Hospital submitted claims with overpayments totaling $267,000 for physician services for calendar years 2009 through 2010. The Hospital and the two independent physicians used a third-party billing company that incorrectly coded these claims by using nonfacility place-of-service codes for services that actually were performed in one of the Hospital's outpatient facilities.

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Exclusions Database Report Fraud
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