While hospitals do not appeal many denials from recovery audit contractors, those denials that are appealed often lead to successful results. Across the nation, hospitals are appealing roughly ...

The Medicare Recovery Audit program has been around for roughly six years now, although it was a demonstration for the first three years. However, fiscal year 2011 was one of the most impactful years ...

With the nationwide rollout of the Recovery Audit Contractor (RAC) program under way, it’s crucial that hospitals and health systems act now to prepare for the process so that they don’t find ...

Following the transition, however, RAC operations will resume and auditors will be able to audit claims for dates of service during the period covered by the pause in operations. CMS published a list ...

CMS has finalized new contracts for its controversial Medicare Fee-for-Service Recovery Audit Contractors (RACs) program, which pays contractors to research and identify Medicare overpayments to ...

Deciding how your own internal processes are going to work once the RAC letters start rolling in is probably one of the most daunting tasks we all are grappling with at the moment. Many hospitals ...

Although many Americans are focused on the key points of the proposed health care reform legislation, health care providers are instead focusing on existing legislation that could negatively impact ...

The American Hospital Association's latest survey on the activities of recovery audit contractors (RACs) indicates that while hospitals are spending a lot of money fighting RACs, they are also ...

Q: We keep hearing about RAC reviews. Are they really going to affect nursing homes? A: They already are. We were recently involved in a RAC audit appeal process. Nursing facilities should be prepared ...

Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, ...

Karen Testman, senior vice president of financial operations at MemorialCare Health System, agrees with the concept of reducing Medicare overpayments, but takes issue with the administrative work it ...

The Medicare Recovery Audit Contractor (RAC) process needs immediate reform, according to a letter to Health and Human Services Secretary Kathleen Sebelius signed by 111 members of the U.S. House of ...