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Accession Number PB2013-108168
Title Medicare Compliance Review of Saint Thomas Hospital for Calendar Years 2009 and 2010.
Publication Date May 2013
Media Count 29p
Personal Author N/A
Abstract Saint Thomas Hospital (the Hospital) is a 541 bed acute care facility located in Nashville Tennessee. According to CMSs National Claims History data, Medicare paid the Hospital approximately $261 million for 26,855 inpatient and 71,176 outpatient claims for services provided to beneficiaries during calendar years 2009 and 2010 (audit period). Our audit covered $28,592,688 in Medicare payments to the Hospital for 3,297 claims that were potentially at risk for billing errors. We selected for review a stratified random sample of 250 claims with payments totaling $3,335,641. These 250 claims had dates of service in our audit period and consisted of 195 inpatient and 55 outpatient claims. Our objective was to determine whether the Hospital complied with Medicare requirements for billing inpatient and outpatient services on selected types of claims.
Keywords Audits
Billing errors
Compliance reviews
Inpatient claims
Outpatient claims
Payment systems
Saint Thomas Hospital

Source Agency Department of Health and Human Services, Washington, DC
NTIS Subject Category 44U - Health Care Delivery Organization & Administration
Corporate Author Department of Health and Human Services, Washington, DC. Office of the Inspector General.
Document Type Technical report
Title Note N/A
NTIS Issue Number 1319
Contract Number N/A

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