Medicare Compliance & Reimbursement - 2012 Issue 35
RAC Audits: One RAC's Decision to Audit E/M Claims Draws Fire
Subscribe or sign in to view the full article.
Article Overview
This article covers a Recovery Audit Contractor’s decision to begin reviewing evaluation and management claims across a broad geographic area and the reaction from physician groups. It explains the scope of the audit activity, the time frame involved, and why the issue drew attention from organizations focused on physician payment, compliance, and appeals. The piece is relevant for coding, compliance, and practice management professionals monitoring audit risk affecting office visit services.
Why This Topic Matters
It highlights audit activity that can affect physician practices, claims review processes, and potential appeals, making it important for anyone tracking compliance exposure and payment integrity reviews.
What You Will Learn
- How a Recovery Audit Contractor audit initiative can affect evaluation and management claims
- Why physician organizations may object to broad review and extrapolation activity
- What geographic areas and time periods were implicated in the audit announcement
- How audit decisions can raise concerns for practices performing face-to-face services
Who Should Read This
- Medical coders
- Coding auditors
- Compliance officers
- Physician practice managers
- Billing staff
- Healthcare attorneys
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com