ICD-10 implementation brings with it a host of concerns and relative anxiety to medical practices of all types. Until offices have begun to use the new guidelines, and fully assimilated their reporting and claims processes, there will be a period of uncertainty. Continue reading
In 2003, Congress created the Recovery Audit (RAC) program to help the Centers for Medicare and Medicaid Services (CMS) find and recover improper payments made by providers of Medicare and Medicaid. It took years, but it was finally implemented nationwide in 2009. Since then, the Recovery Audit program has been under some scrutiny, some calling it a witch hunt and others actually calling it RAC Fraud.
Certainly by now you are familiar with the CMS RAC program. How familiar depends on whether or not you have had the good fortune to go through this process. Regardless if you’ve been audited or not, you should know a little about the process for your own protection as a provider of Medicare or Medicaid fee-for-service patients. Continue reading
The CMS RAC program was designed to correct billing errors mainly caused by medical coding errors, not to prevent healthcare providers from getting what’s due to them. The Medicare and Medicaid systems are fraught with fraud, waste and abuse in addition to honest medical and billing coding errors. Often times these errors actually cost the provider money, which is identified and recovered through the RAC program. Continue reading