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Audit (A-01-11-00522)

08-29-2011
Review of Outpatient Claims Processed by Cahaba Government Benefit Administrators That Included Procedures for the Insertion of Multiple Units of the Same Type of Medical Device in Calendar Years 2008 and 2009

Executive Summary

Of the 58 claims that we reviewed for calendar years 2008 and 2009, Medicare paid 11 incorrectly for outpatient claims processed by Cahaba Government Benefit Administrators, LLC, that included procedures for the insertion of multiple units of the same type of medical device. These incorrect payments were due to hospitals overstating the number of units and related charges, resulting in net overpayments to hospitals totaling $29,000.

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