Medicare Compliance Review of Wesley Medical Center for 2012 and 2013

Wesley Medical Center (the Hospital) (operating in Wichita, Kansas) complied with Medicare billing requirements for 208 of the 246 inpatient and outpatient claims we reviewed. However, the Hospital did not fully comply with Medicare billing requirements for the remaining 38 claims, resulting in overpayments of $182,000 for calendar years 2012 and 2013. Specifically, 27 inpatient claims had billing errors, resulting in overpayments of over $92,000, and 11 outpatient claims had billing errors, resulting in overpayments of over $89,000. These errors occurred primarily because the Hospital did not have adequate controls to prevent the incorrect billing of Medicare claims within the selected risk areas that contained errors.