Revenue Cycle

Medical Necessity RAC Strategies

Recovery Auditor Report, September 30, 2010

After much anticipation, they’ve finally arrived. With the recent CMS approval of issues for DCS, the RAC for Region A, all four of the RACs are actively reviewing claims for medical necessity validation. Now what?

The RAC Report sat down with Michael Taylor, MD, vice president of clinical operations at Executive Health Resources in Newtown Square, PA. Taylor has extensive inpatient and outpatient experience in urban, rural, community and academic settings. Taylor has years of experience and expertise in guiding and assisting hospitals throughout all levels of the Medicare appeals process, including vast experience at the administrative law judge level.

Whether you are a provider that was prepared for the inevitable onset of medical necessity or you are now scrambling to catch up, there are undoubtedly some questions and concerns surrounding the medical necessity. Taylor spent a few minutes discussing strategies with us.

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