While hospitals do not appeal many denials from recovery audit contractors, those denials that are appealed often lead to successful results. Across the nation, hospitals are appealing roughly ...

The Medicare Recovery Audit program has been around for roughly six years now, although it was a demonstration for the first three years. However, fiscal year 2011 was one of the most impactful years ...

With the nationwide rollout of the Recovery Audit Contractor (RAC) program under way, it’s crucial that hospitals and health systems act now to prepare for the process so that they don’t find ...

CMS has finalized new contracts for its controversial Medicare Fee-for-Service Recovery Audit Contractors (RACs) program, which pays contractors to research and identify Medicare overpayments to ...

This post was contributed by Louis J. Goodman, PhD, Board member of the Physicians Foundation and Tim Norbeck, CEO of the Physicians Foundation. We recently received a letter from a young practicing ...

Although many Americans are focused on the key points of the proposed health care reform legislation, health care providers are instead focusing on existing legislation that could negatively impact ...

Deciding how your own internal processes are going to work once the RAC letters start rolling in is probably one of the most daunting tasks we all are grappling with at the moment. Many hospitals ...

Despite the increasing backlog and cost of Recovery Audit Contractor (RAC) appeals, hospitals continue to petition the Centers for Medicare & Medicaid to overturn claim denials, according to the ...

Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with the medical record request limits) may be in for a surprise. Those limits apply only to complex audits, ...

Karen Testman, senior vice president of financial operations at MemorialCare Health System, agrees with the concept of reducing Medicare overpayments, but takes issue with the administrative work it ...