decisionhealth Newsletters, Part B News - 2012 Issue 4 (April)
RAC issue prompts practices to find fee schedule-based overpayments
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Article Overview
This article covers Medicare recovery audit contractor (RAC) overpayment activity tied to fee schedule changes, along with broader compliance issues that can affect how practices identify and respond to overpayments. It is relevant to billing staff, compliance teams, and practice managers who monitor Medicare payments, audit exposure, and repayment timelines.
Why This Topic Matters
Practices need to understand how fee schedule changes, refund obligations, and RAC review processes can create repayment risk over time. The article also highlights why routine claim monitoring and timely overpayment handling matter for Medicare compliance programs.
Article Sections
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Enforcement
Background on Medicare overpayment exposure, RAC review activity, and the compliance concerns raised by recent fee schedule changes.
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2 tips for handling RAC overpayment audits
General operational advice for practices that want to monitor claims affected by RAC activity and track payment changes in their systems.
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4 top RAC facts
A summary of broad RAC audit parameters, notification timing, repayment handling, and related Medicare policy context.
What You Will Learn
- How Medicare fee schedule changes can create overpayment exposure
- What kinds of RAC activity practices should monitor
- How overpayment reporting and repayment timing affect compliance risk
- Which general RAC audit considerations are relevant to claim review and appeals
Who Should Read This
- Medical billers
- Coding professionals
- Practice managers
- Compliance staff
- Revenue cycle teams
Codes Discussed
Code Ranges Discussed
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