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CMS Posts Latest RAC Recovery Dollars

by Denise Wilson in Blog, Compliance Corner, Industry News, News on April 26, 2011 Tags: , , , , ,
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CMS has posted on their website an update of overpayments and underpayments thus far (through March 2011) from the RAC program. The publication is titled 2011 FFS Newlestter. It’s interesting that the overpayments collected for the first three months of 2011 is more than double what was collected during the last three…

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Data Mining for Recent Audit Issues

by Denise Wilson in Blog, Compliance Corner on December 3, 2010 Tags: , , , , , , ,
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One of our client hospital systems recently reported that they have been receiving record requests from the RAC for cases where Procedure Code 96.72 (mechanical ventilation 96+ hours) was billed on a length of stay equal to 4 days. The records are being requested under CGI’s published DRG Validation…

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CMS Posts New or Updated FAQs Related to RAC

by Denise Wilson in Blog, Compliance Corner on November 29, 2010 Tags: , ,
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Last week CMS posted several updates to its Frequently Asked Questions list in regard to the RAC program.

In the ongoing quest to answer the question of whether the RAC can audit the same claim multiple times, one FAQ was updated and a new FAQ was posted.

FAQ # 10007, which…

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CMS Publishes First Issue of New Quarterly Provider Compliance Newsletter

by Denise Wilson in Blog, Compliance Corner on October 6, 2010 Tags: , , ,
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The CMS Medicare Learning Network® (MLN) announced today the publication of the first issue of the new Medicare Quarterly Provider Compliance Newsletter. The purpose of the newsletter is to advise physicians, suppliers, and other FFS providers about how to avoid common billing errors and other erroneous activities when dealing with the…

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Add the New CMS Publications Regarding RAC Issues to Your Reference Library

by Denise Wilson in Compliance Corner on October 5, 2010 Tags: , , ,
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CMS has recently published two new MLN Matters on RAC issues that were identified during the RAC demonstration project. I recommend you add these two MLN Matters articles along with the first one in the series, SE1024 issued July 12, to your RAC reference library because there is good…

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