decisionhealth Newsletters, Part B News - 2007 Issue 10 (October)
RACs: CMS names a new contractor to review the new contractors that review your claims; Who's reviewing the RACs?
Subscribe or sign in to view the full article.
Article Overview
This article covers CMS oversight of Recovery Audit Contractors (RACs), including the addition of a contractor to review RAC activity and the broader expansion of the program. It is relevant for physicians, hospital and practice billing staff, compliance teams, and specialty groups tracking Medicare audit activity. The article also discusses the general categories of claims being scrutinized and the administrative burden associated with responding to RAC review requests.
Why This Topic Matters
RAC activity can affect claim payment, audit exposure, and appeals workload for providers. Understanding the scope of RAC oversight and the types of services being reviewed helps organizations monitor compliance and prepare for audit-related requests.
Article Sections
-
Who's reviewing the RACs?
Overview of CMS oversight of Recovery Audit Contractors and the administrative context behind the review process. The section also addresses expansion of the program and general appeal-related concerns.
-
RACs reviewing drug claims
Summary of the types of services and payment issues RACs have been reviewing, with emphasis on general claim categories reported by physician groups and CMS representatives.
What You Will Learn
- How CMS is overseeing Recovery Audit Contractors
- Why RAC activity has drawn scrutiny from providers
- What kinds of claim categories have been reviewed in the RAC program
- How RAC-related audit activity can affect provider workflow and appeals
Who Should Read This
- Physicians
- Practice managers
- Billing and coding staff
- Compliance officers
- Hospital revenue cycle teams
- Specialty society staff
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com