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Audit (A-01-10-00523)

11-03-2010
Verification of Mid Coast Hospital's Refund of Place-of-Service Overpayments for Calendar Years 2004-2007

Executive Summary

We determined that Mid Coast Hospital (the Hospital) submitted claims with overpayments totaling $208,000 for physician services for calendar years (CY) 2004 through 2007. The Hospital, billing on behalf of its physicians, incorrectly coded these claims by using nonfacility place-of-service codes for services that were actually performed in one of the Hospital's outpatient facilities. To date, the Hospital has made refunds to National Heritage Insurance Corporation for overpayments totaling $146,000.

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