Christian Hospital overbilled Medicare by $341,221 in 2012 and 2013 due to improper claims, according to a new report from the Department of Health and Human Services’ Office of Inspector General (OIG).
Medicare paid Christian, the 485-bed hospital in north St. Louis County that is part of the BJC HealthCare system, approximately $145 million for 127,343 outpatient and 11,160 inpatient claims during 2012 and 2013, according to the report. The OIG completed an audit of $2.8 million of these Medicare payments for 199 claims that were viewed as at risk for billing errors.
Christian complied with the Medicare billing requirements for 95 of the claims reviewed, according to the report. However, billing errors for the remaining 104 claims resulted in the $341,221 overpayment.
In a letter sent to the OIG in response to the report, Kathleen Boschert, BJC’s director of corporate compliance, stated that the hospital agreed with the identified billing errors and had fully reimbursed the overpayment amounts.
Bret Berigan, spokesman for Christian, said the overpayments “reflect improper coding on procedures due to complex coding requirements.”
“These audits were focused on a set of select procedures identified by the OIG as being at high risk nationally for incorrect coding due to the complexities,” Berigan said in an emailed statement. “Through the auditing process, we have increased education and training of staff at Christian Hospital and across BJC in regard to coding of these procedures. We continue to work diligently to stay current with changes and we maintain ongoing open dialog with our regional OIG to improve accuracy and ensure that any improper coding is corrected.”