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Welcome to the HRP Press Room

 

Date:                 July 10, 2008

Contact:            Amanda Ceccato

Phone:              (732) 292-1100

 

Prepare For RAC Audits, Know What They Are Looking For

MANASQUAN, N.J. -- After a successful recovery of $371.5 million by the Centers for Medicare and Medicaid Services (CMS) recovery audit contractor (RAC) demonstration of 2007, the medical community should know what the auditors are looking for and how to prevent their claims being labeled an overpayment with an expected nation-wide implementation by 2010.

“Prepare for RAC Audits, Know What They Are Looking For,” a new free report by the editorial staff of Healthcare Reimbursement Monitor offers valuable insight to prepare organizations for the upcoming RAC audits threatening millions of dollars in claims.

Dr. Duane Abbey, president of Abbey and Abbey, Consultants, Inc. discussed and shared useful tips to ensure paid claims are not later rejected by RAC auditors during an audio conference presented by Healthcare Reimbursement Monitor, titled, “Identifying Top Reimbursement Compliance Issues in 2008: Preparing for OIG (Office of Inspector General), Medicare Contractor and RAC Audits.”

“RAC auditor contractors are being paid on a contingency basis – in other words, [they're paid] a percentage of what they recover. I went back to 1997 because the OIG has put out an advisory bulletin [saying] that consultants were not to be hired on a contingency basis. So it's interesting, the hospital can't hire a consultant on a contingency, but CMS can,” said Abbey.

Abbey said the first step to take in avoiding claim denials is identifying the issues. “Only the imaginations of RACs will really delimit the number and type of issues that may be raised,” said Abbey, but identifying what might be an issue with RAC auditors will only be beneficial.

The free report highlights Abbey's predicted RAC audit issues, for example the emergency department, coding and medical necessity will be examined and solutions given to prevent auditors determining an appropriate claim an overpayment.

Healthcare Reimbursement Monitor is a monthly national newsletter delivering top news on reimbursement issues, such as Medicare and Medicaid rulings, the Pay-for-Performance movement and physician fee cuts as determined by the Centers for Medicare and Medicaid Services.

For more information on Healthcare Reimbursement Monitor, please visit http://www.healthresourcesonline.com/management/25nl.htm.

A CD-ROM recording of the speaker presentations and all conference materials for “Identifying Top Reimbursement Compliance Issues in 2008: Preparing for OIG (Office of Inspector General), Medicare Contractor and RAC Audits” is now available to order online or by calling toll free (800) 516-4343.
For more information visit http://www.healthresourcesonline.com/edu/medicarevbp.htm..

Address: Healthcare Reimbursement Monitor, Health Resources Publishing, 1913 Atlantic Ave., Suite 200, Manasquan, NJ 08736; (732) 292-1100, www.healthrespubs.com

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