tci Medicare Compliance & Reimbursement - 2007 Issue 5
IRFs: Heads Up--OIG Is Scrutinizing Your Transfer, Discharge Billings
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Article Overview
This article covers an OIG audit of inpatient rehabilitation facility billing under Medicare’s transfer policy and describes a fiscal intermediary’s response to identified claim status errors. It is relevant to hospital and rehab facility coders, billers, compliance staff, and revenue cycle professionals who monitor inpatient claims, patient status coding, and payment adjustment activity. The article provides a high-level discussion of the audit findings, the type of billing pattern reviewed, and the intermediary’s plan for correcting improperly billed claims.
Why This Topic Matters
The topic affects Medicare reimbursement, claim accuracy, and compliance for inpatient rehabilitation facilities. It highlights the importance of correct patient status reporting and the potential for overpayment recovery when transfer-related claims are identified.
What You Will Learn
- What the article says about Medicare transfer-related billing oversight
- How an OIG audit can lead to claim correction activity
- Why inpatient rehabilitation facility patient status reporting matters
- What kinds of Medicare claims were reviewed in the audit
- How fiscal intermediaries may respond to identified billing errors
Who Should Read This
- Inpatient rehabilitation facility coders
- Hospital outpatient and inpatient billing staff
- Revenue cycle professionals
- Compliance officers
- Medical auditors
- Medicare reimbursement specialists
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