Medicare Compliance Review of Freeman Hospital for 2011 and 2012

Freeman Hospital (the Hospital) (operating in Joplin, Missouri) complied with Medicare billing requirements for 180 of the 225 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 45 claims, resulting in overpayments of $311,000. Specifically, 42 inpatient claims had billing errors, resulting in overpayments of $304,000, and 3 outpatient claims had billing errors, resulting in overpayments of $7,000. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.