Revenue Cycle

Revenue Cycle Articles by Topic: Auditing

HealthDataInsights posts several new RAC DME claim issues

  • The RAC Report, Issue 23, November 12, 2009

    HealthDataInsights (HDI) has added multiple new RAC issues to their CMS-approved list in late...

Could RAC mass adjustment changes mean increase in automatic audits?

  • The RAC Report, Issue 23, November 12, 2009

    Providers who believe their RAC denials will be limited to 200 every 45 days (corresponding with...

RAC vs. CERT audits: Do you know the difference?

  • The RAC Report, Issue 23, November 12, 2009

    The Comprehensive Error Rate Testing (CERT) Hospital Payment Monitoring Program is one of the ways...

Region B and D RACs post new issues, all states now approved for audits

  • The RAC Report, Issue 22, October 29, 2009

    CGI, the RAC for Region B, has posted three new issues for review in Illinois, Indiana, Kentucky...

CMS releases new FAQ on N432

  • The RAC Report, Issue 22, October 29, 2009

    On October 15 CMS released an FAQ on the appearance of code N432 on remittance advice.

Sneak preview: Comparing appeal rates for RACs vs. claims processing contractors

  • The RAC Report, Issue 22, October 29, 2009

    The high number of claims determinations appealed was a measure of dissatisfaction with the RAC...

Audits underway, but hospital continues to refine in preparation for RACs

  • The RAC Report, Issue 22, October 29, 2009

    St. Joseph Medical Center in Houston has been preparing for RACs for months now, says Cucharras...

Escalating Medicare and Medicaid auditing on the horizon

  • The RAC Report, Issue 22, October 29, 2009

    There’s no question that audit activity is escalating and the healthcare provider community...

AHA RAC Program Update answers provider questions

  • The RAC Report, Issue 21, October 15, 2009

    As of September 18, all four RACs were conducting automated audits, according to an October 6...

Two new issues for RAC Region D

  • The RAC Report, Issue 21, October 15, 2009

    HealthDataInsights (HDI) has announced two new issues for region D.

CMS plans appeals town hall meeting

  • The RAC Report, Issue 21, October 15, 2009

    CMS planned a town hall meeting for November 5 from 1-3:30 p.m. Eastern Time to discuss appeals of...

Five last-minute tips to prepare for RACs

  • The RAC Report, Issue 21, October 15, 2009

    RACs have begun auditing at this point, and providers in some states may have received their first...

CMS releases new, updated RAC FAQs

  • The RAC Report, Issue 21, October 15, 2009

    CMS issued the following new RAC FAQ on its Web site September 30: If I am a chain provider whose...

OIG plans to review Medicare, Medicaid auditing programs

  • The RAC Report, Issue 21, October 15, 2009

    In 2010, the OIG plans to review the progress of many Medicare and Medicaid auditing programs, as...

Have you been audited by a RAC?

  • The RAC Report, Issue 21, October 15, 2009

    If you’ve been audited by a RAC—for example, if you’ve received a demand letter...

Last RAC announces first issues: DCS posts approved issues for Region A

  • The RAC Report, Issue 20, October 1, 2009

    DCS Healthcare has released its first CMS-approved issues for audits in Region A. The three issues...

CMS releases new RAC FAQ

  • The RAC Report, Issue 20, October 1, 2009

    CMS released the following new RAC FAQ September 25: How long is the Recovery Audit Contractor...

Providers seek information on Medicaid Integrity Contractors as aggressive auditing rolls out nationwide

  • The RAC Report, Issue 20, October 1, 2009

    At this point, thanks to a three-year demonstration project and a plethora of available information...

Revenue Cycle Institute posts new White paper and tool

  • The RAC Report, Issue 20, October 1, 2009

    The Revenue Cycle Institute has released a new White Paper, “Sepsis and Septicemia: Clear Up...

Q&A: Medically Unlikely Edits and Once in a Lifetime codes

  • The RAC Report, Issue 19, September 17, 2009

    Q: Several RACs are looking for once in a lifetime procedure coding errors. Wouldn’t...

CMS releases transmittal on RACs and LCDs

  • The RAC Report, Issue 19, September 17, 2009

    CMS released on September 11 transmittal 302, which outlines the authority RACs, MACs, and other...

Revenue Cycle Institute launches new Web site, posts new RAC tool

  • The RAC Report, Issue 19, September 17, 2009

    We’ve gathered the latest RAC information on the CMS-approved RAC issues in each state and...

RAC issues approved for North Carolina

  • The RAC Report, Issue 19, September 17, 2009

    Connolly, the RAC for Region C, approved several issues for North Carolina providers on September...

CGI posts first approved issues for RAC review in Region B

  • The RAC Report, Issue 18, September 3, 2009

    Region B, get ready. RACs may begin auditing at any time in several Region B states. CGI Federal...

RAC audit issues approved for Alabama, Georgia

  • The RAC Report, Issue 18, September 3, 2009

    On September 1 Connolly, the RAC for Region C, has approved several issues for which it can audit...

Connolly posts two RAC-approved issues for DME providers

  • The RAC Report, Issue 18, September 3, 2009

    Connolly, the Region C RAC, has been approved to audit Durable Medical Equipment (DME) providers...

Update: New issues approved for Florida

  • The RAC Report, Issue 18, September 3, 2009

    Connolly Healthcare, the RAC for region C, has now posted issues for review in Florida, including...

MACs vs. RACs: Could a little friendly competition mean more bad news for healthcare providers?

  • The RAC Report, Issue 18, September 3, 2009

    What’s the difference between a MAC and a RAC? When it comes to protecting Medicare dollars...

CMS updates RAC FAQ

  • The RAC Report, Issue 18, September 3, 2009

    CMS updated the three RAC FAQ on August 26.

Revenue Cycle Institute posts free RAC tool

  • The RAC Report, Issue 18, September 3, 2009

    Are you looking for help writing your RAC appeal letters? If so, the Revenue Cycle Institute hopes...

CGI posts first approved issues for RAC review in Region B

  • HCPRO Website, Issue 1, August 26, 2009

    CGI Federal, the RAC for Region B, has posted its first set of issues eligible for RAC audits in...

Connolly posts issues for review in Florida: Issues differ between Region C states

  • The RAC Report, Issue 17, August 20, 2009

    Connolly Healthcare, the RAC for region C, has now posted issues for review in Florida. RACs may...

HealthDataInsights launches new RAC Web site, posts issues eligible for audits

  • The RAC Report, Issue 17, August 20, 2009

    HealthDataInsights, Inc. (HDI), launched its new RAC Web site, and posted the first set of issues...

Self-examination can help ensure compliance with new CMS-approved audit issues

  • The RAC Report, Issue 17, August 20, 2009

    Connolly and HealthDataInsights (HDI) have released their first set of “approved...

Trivia answer revealed: What do you know about the RAC Validation Contractor?

  • The RAC Report, Issue 17, August 20, 2009

    Thanks to all who participated in our trivia contest in the previous issue of The RAC Report.

RAC Audits to begin in Region C: Connolly posts issues eligible for RAC review

  • The RAC Report, Issue 16, August 6, 2009

    Heads up, healthcare providers: Connolly Healthcare, the RAC for Region C, has posted the first set...

Surprise! Voluntary refunds don't protect against RACs

  • The RAC Report, Issue 16, August 6, 2009

    For many providers, self-auditing has become an important RAC preparation tool. Certainly, internal...

FAQ: Appealing automated reviews

  • The RAC Report, Issue 16, August 6, 2009

    Q: Can we appeal a RAC automated audit that results in a denial?

Free Sample: RAC Tracking Spreadsheet

  • The RAC Report, Issue 16, August 6, 2009

    Have you developed a way to manage the complex task of tracking your RAC requests and appeals? If...

Answer and win! What do you know about the RAC Validation Contractor?

  • The RAC Report, Issue 16, August 6, 2009

    Having a strong knowledge of RACs (e.g., what to expect, timelines, how to appeal, etc.) is...

Medicaid Integrity Contractors: Coming to a hospital near you

  • The RAC Report, Issue 15, July 23, 2009

    Nearly 500 Medicaid audits are under way in 17 states, and the program will roll out to the entire...

Master wound care coding to prepare for RAC audits

  • The RAC Report, Issue 11, May 28, 2009

    Coders should arm themselves with as much wound care and coding knowledge as possible to prepare...

Revenue Cycle Institute releases new White Papers on Incident to and E/M auditing

  • The RAC Report, Issue 9, April 30, 2009

    The HCPro Revenue Cycle Institute has just released two new complimentary White Papers.

Tip: Ask the right questions to ensure an effective admissions review program

  • The RAC Report, Issue 8, April 16, 2009

    Are you certain your admissions review program is as effective as it needs to be so you can avoid...

Understand diagnosis coding to protect against auditor scrutiny

  • The RAC Report, Issue 4, February 19, 2009

    When coding for outpatient procedures, coders should base the patient’s diagnosis on his or...

CMS RAC Open Door forum update

  • The RAC Report, Issue 7, November 13, 2008

    CMS will be holding a special RAC Open Door Forum for Part B providers Thursday, November 13, at...

Update: CMS delays RAC permanent program

  • The RAC Report, Issue 7, November 13, 2008

    By now you know that CMS announced a delay in the Medicare RAC permanent program. But what you may...

In the news: SSA seeks input on increasing efficiency of ALJ hearings

  • The RAC Report, Issue 7, November 13, 2008

    The Social Security Administration is seeking comments on a proposed rule that will attempt to...