Report Materials
The objective of our audit was to examine the Medicare Part B payments for services billed by Community Urgent Care Medical Group (Community) for the period January 1, 1995 through July 31, 1999 to determine if the payments (about $3.7 million) were appropriate. Our review disclosed that 29 services in our random, statistical sample of 100 claims (135 services) were overpaid. The 29 overpaid services included 23 which had been upcoded, 3 for which the documentation did not support the services billed, and 3 for which the documentation did not support that a teaching physician was present when a resident performed the service. Based upon our random sample, we estimate that Community received $266,236 in Medicare overpayments during the audit period. We are recommending that Community refund the identified overpayment.
Notice
This report may be subject to section 5274 of the National Defense Authorization Act Fiscal Year 2023, 117 Pub. L. 263.