Medicare Compliance Review of North Carolina Baptist Hospital for Claims Paid From January 1, 2013, Through August 31, 2014
North Carolina Baptist Hospital (the Hospital), located in Winston Salem, North Carolina, complied with Medicare billing requirements for 209 of the 246 inpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 37 claims, resulting in net overpayments of approximately $221,000 for the audit period. On the basis of our sample results, we estimated that the Hospital received overpayments of at least $1.4 million for the audit period. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.
Filed under: Center for Medicare and Medicaid Services