According to the suit that was made public Thursday, the alleged glitch in the system has resulted in hundreds of millions of dollars of overbilling. Epic refutes the allegations.
"The Department of Justice did its own expert review and decided not to move forward," Epic spokeswoman Meghan Roh said in a statement. "The plaintiff's assertions represent a fundamental misunderstanding of how claims software works."
[...]
Geraldine Petrowski, who worked at WakeMed Health in Raleigh, North Carolina, between 2008 and 2014, filed the complaint that claims that Epic's billing software defaults to charging for both the applicable "base units" for anesthesia provided on a procedure as well as the actual time taken for the procedure, resulting in payers being overcharged for anesthesia.
"This unlawful billing protocol has resulted in the presentation of hundreds of millions of dollars in fraudulent bills for anesthesia services being submitted to Medicare and Medicaid as false claims," Petrowski said in the complaint.
She also seeks to bolster her case, alleging that MD Anderson Cancer Center billed for seven hours of anesthesia for a prostate removal that took less than five hours.
Petrowski served as hospital liaison for the WakeMed's rollout of Epic's software, when she came across the anesthesia billing issues, developing "major concerns" about incorrect billing, she said in the complaint.
She worked as a compliance review specialist at from September 2008 to September 2012 and then as the supervisor of physicians' coding through May 2014. In 2015, was the liaison for the hospital's Epic go-live.
Source: Healthcare IT News (View full article)
Posted by Dan Corcoran on November 6, 2017 06:59 AM
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