Mistakes are part of daily life – including the life of a business. Human error is inevitable, and most day-to-day mistakes do not end up costing much in the long run. In many cases, mistakes can teach valuable, long-term lessons at little cost.
However, in some cases, simple, unintended errors end up costing a tremendous amount of money. Just ask Dustin Johnson, an elite professional golfer who has spent much of his career ranked among the top 10 in the world.
In the 2010 PGA Championship at Whistling Straights, Johnson held a one-shot lead entering the final hole. He appeared to have bogeyed the hole, which would have tied him for first place and entered him into a playoff with two other competitors. However, upon review, he received a two-stroke penalty for mistakenly grounding his club in a bunker – a forbidden move in the rules of golf – dropping him to a tie for fifth place.* Johnson collected a nice $271,000 paycheck for his fifth-place tie, but the champion took home an astounding $1.35 million in prize money.
The story has made weekend golfers feel much better about their own mistakes, serving as a reminder that even the best players can occasionally lose focus. Johnson was not trying to give himself a competitive advantage by grounding his club. This was a classic case of unintended human error.
In healthcare claims, unintended human errors can be equally costly and more difficult to identify. That is why Healthcare Horizons provides a 100% comprehensive audit of all claims.
Healthcare Horizons once identified an instance for a client in which a surgical implant was mistakenly billed at $777,000 instead of $77,000. You can read more here. Since the reimbursement was based on a percentage of the charges, the incorrect billed amount resulted in an overpayment of $300,000. We were able to identify the error and recover the overpayment for the client.
Mistakes will happen, but in healthcare claims, it is essential to have processes in place to identify the errors, map out the root causes, and develop a plan for recovery. We would love to talk more about how we can put such plans in place for you with a comprehensive claims audit. Drop us a line today.
*Source – Pelanda, Brian. “What’s a ‘Bunker’?: The Curious Case of How Dustin Johnson Lost the 2010 PGA Championship and Why the PGA Must Revise the Now Infamous Local Rule at Whistling Straits”. Entertainment, Arts and Sports Law Journal.