tci Medicare Compliance & Reimbursement - 2014 Issue 3
Audits: Your Facility Could Be On the OIG Hit List
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Article Overview
This article summarizes an OIG discussion of recovery audit contractor findings and CMS responses to improper payments identified in prior audits. It is relevant for hospital, physician, and billing professionals who want a high-level view of audit risk areas, appeal trends, and the types of Part B claim issues that continue to attract attention. The piece provides a non-technical overview of the audit environment and the general categories of claims concerns discussed in the report.
Why This Topic Matters
Understanding audit findings and oversight priorities helps facilities and practices anticipate compliance pressure, review billing processes, and assess where claim vulnerabilities may be concentrated.
What You Will Learn
- How OIG and CMS are discussing prior RAC audit findings
- Which broad provider types were most affected by improper payments
- What the article says about appeal activity and outcomes
- Why certain Part B billing issues remain a focus of oversight
Who Should Read This
- Hospital billing staff
- Physician practice coders
- Revenue cycle professionals
- Compliance officers
- Healthcare auditors
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