ED Coding & Reimbursement Alert - 2013 Issue 31
Recovery Audit Contractors: CMS Has Yet to Follow Through on RAC Recommendations, OIG Says
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Article Overview
This article reviews an OIG report about Recovery Audit Contractors and CMS’s response to RAC-identified improper payments, referrals, and performance issues. It is relevant to Medicare billing and compliance staff, coders, auditors, and practice managers who want a high-level view of RAC oversight trends, appeal patterns, and broad vulnerability areas discussed in the report.
Why This Topic Matters
It helps readers understand how CMS oversight and RAC findings may affect Medicare claim review, audit risk, and compliance priorities across provider settings.
What You Will Learn
- What the OIG reviewed in its report on Recovery Audit Contractors and CMS actions
- Which broad provider and payment areas were most often associated with improper payments
- How the article frames appeals, referrals, and follow-up on RAC findings
- Why the report suggests continued attention to Medicare billing compliance and claim accuracy
Who Should Read This
- Medical coders
- Billing staff
- Compliance officers
- Practice managers
- Hospital revenue cycle teams
- Medicare auditors
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