decisionhealth Newsletters, Part B News - 2006 Issue 9 (September)
OIG raps double-dipping for inpatient radiology services
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Article Overview
This article explains new and renewed CMS enforcement attention on inpatient radiology technical component claims after OIG identified overpayments tied to hospital stays. It is relevant to radiology suppliers, billing staff, compliance teams, and revenue cycle professionals who handle Part B claims, inpatient status checks, and postpayment recovery activity. The piece focuses on the general nature of the audit findings, CMS response, and the broader compliance concerns surrounding radiology billing in the hospital setting.
Why This Topic Matters
It matters because inpatient status can affect whether radiology technical component claims are payable under Part B, and the article highlights government efforts to identify and recover claims paid in error. Providers that bill imaging services need to understand the compliance risk, especially when services occur near a hospital admission or discharge.
What You Will Learn
- Why CMS is increasing review of inpatient-related radiology claims
- How OIG audit findings prompted recovery efforts
- What kinds of operational issues can lead to improper claims submission
- How historical audit activity relates to current enforcement attention
Who Should Read This
- Radiology suppliers
- Medical billing staff
- Coding professionals
- Compliance officers
- Revenue cycle managers
- Hospital and physician practice administrators
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