Review of High-Dollar Payments for Medicare Part A Outpatient Claims Processed by TriSpan Health Services for the Period January 1, 2003, Through December 31, 2003

None of the four high-dollar payments ($50,000 or more) that TriSpan Health Services (TriSpan) made for outpatient services in calendar year 2003 were appropriate. Our analysis indicated that the resulting overpayment totaled $227,547, of which $104,521 was recovered prior to the end of our audit.TriSpan is a Medicare Part A fiscal intermediary serving more than 1,800 Medicare providers in Mississippi, Louisiana, and Missouri.

We recommended that TriSpan inform us of the status of the recovery of the $123,026 in identified overpayments and use the results of this audit in its provider education activities. TriSpan agreed with our recommendations.