Medicare Compliance Review of Swedish Medical Center - First Hill

Swedish Medical Center - First Hill (Swedish), located in Seattle, Washington, complied with Medicare billing requirements for 81 of the 257 inpatient and outpatient claims we reviewed. However, Swedish did not fully comply with Medicare billing requirements for the remaining 176 claims, resulting in net overpayments of approximately $937,000 for calendar years (CYs) 2010 through 2012 (166 claims) and CY 2009 (10 claims). These overpayments occurred primarily because Swedish did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.