Catherine Boerner (cboerner@boernerconsultingllc.com) is President of Boerner Consulting LLC in New Berlin, WI.
The Office of Inspector General (OIG) tends to have a reason when your hospital is included in one of its audits. The data mining and data analysis typically will be the reason you are on the radar. This is why compliance professionals need to be aware when the audit letters and result letters arrive. This puts your hospital on notice when there are errors to conduct reasonable diligence. Oftentimes these result letters explain what is expected, such as: “Please review the claims listing that is provided with this notification letter to determine whether overpayments exist and whether any similar overpayments exist within the six-year lookback period.” These result letters also explain the 60-day repayment rule when you identify errors.
