University of North Carolina Health Care plans to appeal a federal claim that it overbilled Medicare by about $2.5 million, saying it only improperly billed in three of cases pointed out by investigators.
The health system is requesting a meeting with auditors to go over the results of the Office of Inspector General's report.
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The federal insurer claims it paid UNC $371 million for 16,145 inpatient and 248,812 outpatient claims between Jan. 1, 2011 and Sept. 30, 2012. The audit specifically targeted 2,462 claims that were at risk for being improperly billed, equaling $33.1 million in reimbursements. Of that group, the OIG scrutinized a sample of 251 claims and found UNC improperly billed in 59 cases.
“Specifically, 58 inpatient claims had billing errors resulting in net overpayments of $451,412 and one outpatient claim had a billing error resulting in an overpayment of $583,” the report states.
Using that sample, the OIG estimated UNC improperly billed Medicare $2.5 million.
But UNC officials say they were entitled to the reimbursements in all but three cases.
The OIG said it stands by its audit.
By appealing, UNC can elect to make its case in hearings before administrators, and could even negotiate a settlement.
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