Review of Medicare Credit Balances at Hospitals in South Carolina

EXECUTIVE SUMMARY:

This final report discloses that Medicare accounts receivable credit balances included unidentified overpayments totaling an estimated $1.3 million for 17 hospitals in South Carolina serviced by Blue Cross and Blue Shield of South Carolina as the Medicare intermediary. The overpayments existed because neither the hospitals nor the intermediary reviewed credit balances or processed adjustments timely. We recommended recovery of the overpayments and procedural improvements to ensure that the hospitals and the intermediary perform more timely reviews.