HCPro, JustCoding Inpatient - 2021 Issue 21 (May)
Healthcare News: OIG audit finds Virtua Our Lady of Lourdes Hospital received $4.8 million in Medicare overpayments
May 25th, 2021
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Article Overview
This article covers an Office of Inspector General compliance audit of Virtua Our Lady of Lourdes Hospital and summarizes alleged Medicare overpayments tied to inpatient and outpatient claim review. It is relevant to hospital compliance, revenue integrity, and coding/audit professionals who monitor documentation support, claim accuracy, and Medicare billing oversight. The article also outlines the general categories of corrective actions recommended by the OIG.
Why This Topic Matters
It highlights how Medicare audit findings can affect hospital reimbursement, repayment exposure, and internal billing controls, making it useful for compliance and coding teams responsible for claim accuracy and documentation support.
What You Will Learn
- What the OIG audit reviewed at a high level
- The broad categories of inpatient and outpatient claim issues identified
- The types of compliance and documentation controls emphasized in the audit recommendations
- Why hospital billing oversight and record support are important in Medicare audits
Who Should Read This
- Hospital compliance staff
- Inpatient and outpatient coding professionals
- Revenue integrity teams
- Medical auditors
- Healthcare administrators
Codes Discussed
Modifiers Discussed
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