Eli's Rehab Report
Audits: OIG Continues to Target Medical Necessity
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Texas City, Texas -- Good documentation always counts -- even after you're reimbursed for those services -- because sooner or later, the HHS Office of Inspector General could be scrutinizing your records. That's what happened with Gulf City Health Care Center in Texas City, Texas. The OIG reviewed the facility's rehabilitation claims for medical necessity and adequate documentation. Of the 100 claims the OIG sampled, Gulf submitted 69 claims that did not meet Medicare requirements, according to the Office's July 13 report. The dollar figure: "Based on our sample results, we estimate Medicare overpaid Gulf at least $671,456 for services that did not meet Medicare requirements," the OIG said, with the recommendation that Gulf refund Medicare for this amount. Gulf disagreed with the findings.
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Texas City, Texas -- Good documentation always counts -- even after you're reimbursed for those [...]