Revenue Cycle

Q&A: RACs and Physician Offices

Recovery Auditor Report, June 25, 2009

Q. Our Midwestern physician practice that has more than 30 physicians. Are physician offices “vulnerable” or on the radar for RACs?
A: Yes, they are vulnerable. In addition, CMS has stated that when a RAC denies a hospital stay or service for medical necessity, the associated physician services would also be subject to denial.
Editor’s note: Tanja Twist, director of Patient Financial Services at Methodist Hospital of Southern California answered the previous question. She will also be speaking in the upcoming HCPro audio conference, “Medicare Appeals: Practical and Compliant Procedures for Overturning Denials,” as well as at the upcoming conference, “Medicare Compliance Forum: A Strategic Approach to RACs, Observation Status and the Role of Physician Advisors,” which will be held in Atlanta this October.

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