Medicare Compliance Review of University of Tennessee Medical Center

The University of Tennessee Medical Center (the Hospital) complied with Medicare billing requirements for 219 of the 236 inpatient and outpatient claims that we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 17 claims, resulting in overpayments of $42,000. These 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.