Revenue Cycle

Revenue Cycle Articles by Topic: Recovery Audit Contractors

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...

Have you been audited by a RAC?

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

    If you’ve been audited by a RAC–for example, perhaps you’ve received a demand...

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...

CMS clarifies RAC exception authority

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

    On September 11, CMS published Transmittal 302 that updated the Program Integrity Manual on Local...

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...

Last RAC announces first issues for audits

  • Patient Access Weekly Advisor, Issue 38, September 23, 2009

    The RAC field is set.

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

  • Patient Access Weekly Advisor, Issue 38, September 23, 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...

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...

MACs vs. RACs: could competition mean more bad news for providers?

  • Patient Access Weekly Advisor, Issue 36, September 9, 2009

    Might there be a little friendly competition between RACs and MACs?

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...

Free RAC tracking tool sample

  • Patient Access Weekly Advisor, Issue 35, September 2, 2009

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

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...

CMS revises selection criteria for RAC adjustment crossover claims and fully reimbursable Part B claims

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

    On August 7, CMS issued transmittal R1793CP to modify one aspect of the logic that the Part A...

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 Region D News Alert: HealthDataInsights launches new RAC Web site, posts issues eligible for audits

  • HCPRO Website, Issue 1, August 13, 2009

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

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...

Avoid RAC technical denials to protect reimbursement

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

    Do not get a technical denial. Do not get a technical denial. Do not get a technical...

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...

CMS releases two new FAQ on RACs and MACs

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

    CMS released two new FAQ on July 15. The questions are: If the incumbent Part B carrier is awarded...

Let's discuss the RAC discussion period

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

    It seems that many providers still struggle to understand the RAC discussion period that CMS has...

CMS clarifies how it will treat claims associated with denied inpatient stays

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

    CMS is often asked about other claim types that may be affected by a full inpatient denial and if...

Revenue Cycle Institute releases POA White Paper

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

    The Revenue Cycle Institute has released a new white paper, “Present on Admission: Accurate...

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...

CMS Releases RAC Audit Phase-in Strategy: Complex reviews to arrive as soon as August

  • Patient Access Weekly Advisor, Issue 29, July 22, 2009

    CMS released further information June 24 on its RAC Web site letting healthcare providers know when...

Physician advisors and RACs: Saving grace, defending dollars

  • The RAC Report, Issue 14, July 9, 2009

    When it comes to surviving RACs, effective physician advisors can be a “saving grace,&rdquo...

Have you had an experience with Medicaid Integrity Contractors?

  • The RAC Report, Issue 14, July 9, 2009

    If you’ve had experience with Medicaid Integrity Contractors (MIC), we want to hear from you!

CMS updates Medicare Financial Management Manual RAC information

  • The RAC Report, Issue 13, June 25, 2009

    On June 12, CMS updated the Medicare Financial Management Manual with information pertaining to the...

Hospital shares experience, tips for surviving RAC audits

  • The RAC Report, Issue 13, June 25, 2009

    One of the best ways to prepare for a RAC audit comes in learning from survivors. Elizabeth Lamkin...

Q&A: RACs and Physician Offices

  • The RAC Report, Issue 13, June 25, 2009

    Q. Our Midwestern physician practice that has more than 30 physicians. Are physician offices...

Essential questions every HIM director should ask about RAC record requests

  • The RAC Report, Issue 13, June 25, 2009

    When planning for RAC record requests, HIM directors should ask several essential questions.

Reimbursement for medical record copying costs

  • The RAC Report, Issue 13, June 25, 2009

    Q: If you submit requested medical records to RACs via CD, are you still reimbursed copying costs...

Additional CMS RAC FAQ clarify provider questions

  • The RAC Report, Issue 12, June 11, 2009

    CMS released 14 new RAC FAQ June 3.

CMS postpones RAC complex reviews of medical necessity until 2010

  • The RAC Report, Issue 12, June 11, 2009

    CMS anticipates RAC automated reviews will begin in late June and July, according to Marie Casey...

CMS replaces the term 'observation status' with 'observation services'

  • The RAC Report, Issue 12, June 11, 2009

    In the July 2009 quarterly updates, CMS revised portions of both the Claims Processing Manual and...

Take our survey; Be part of a comprehensive look at national RAC preparedness

  • Patient Access Weekly Advisor, Issue 21, June 3, 2009

    What is your facility doing to prepare for a RAC? We want to know.

CMS updates RAC audit timeline: complex reviews still months away

  • Patient Access Weekly Advisor, Issue 21, June 3, 2009

    Get ready for RAC automated reviews this month and next.

CMS releases four new and updated RAC FAQ

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

    CMS released four new and updated RAC FAQ on May 19. The FAQ range from the broad ("Why is CMS...

Q&A: RACs and InterQual

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

    Q: If my hospital is not using the latest InterQual criteria, could that chart be pulled by the RAC...

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...

RACs and Medicare Advantage

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

    Q: Are the Medicare Advantage plans included in RAC audits?

Take our survey; Be part of a comprehensive look at national RAC preparedness

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

    We invite you to take our comprehensive survey on what your facility is doing to prepare for the...

CMS releases new RAC FAQ

  • The RAC Report, Issue 10, May 14, 2009

    CMS released a new FAQ on the Recovery Audit Contractor (RAC) program April 29 with important news...

News: CMS posts slide presentation, RAC Open Door Forum call transcript, recording

  • The RAC Report, Issue 10, May 14, 2009

    CMS posted a RAC program slide presentation, “Recovery Audit Contractors (RACs) and Medicare...

Top 10 lessons learned from the RAC demonstration program

  • The RAC Report, Issue 10, May 14, 2009

    The RAC demonstration project has come and gone, but many providers learned valuable lessons during...

Understand the new AHA RACTrac initiative

  • The RAC Report, Issue 10, May 14, 2009

    The American Hospital Association (AHA) plans to launch a Web-based survey as part of a larger...

Revenue Cycle Institute announces 'Medicare Compliance Forum: A Strategic Approach to RACs, Observation Status and the Role of Physician Advisors'

  • The RAC Report, Issue 10, May 14, 2009

    The “Medicare Compliance Forum: A Strategic Approach to RACs, Observation Status and the Role...

CMS posts RAC Open Door Forum call transcript, recording

  • Patient Access Weekly Advisor, Issue 17, May 6, 2009

    Get your CMS minutes from its RAC call here.

CMS posts RAC Open Door Forum call transcript, recording

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

    CMS has posted the recording, transcript and other related information from the April 8 RAC Open...

AHA issues Member Advisory on RAC program

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

    The American Hospital Association (AHA) has shared what it knows about RACs via a Member...

Q&A: Medical record request limit calculations

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

    Q: We have been trying to calculate the outpatient hospital medical record request limits...

Recovery Audit Contractor Defense conference recordings available

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

    Recordings of the following “Recovery Audit Contractor Defense: A RAC Readiness Summit&rdquo...

Lawsuit says RACs violate CMS' own regulations

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

    Are RACs violating CMS’ own rules? Palomar Medical Center in Escondido, CA believes they are.

Did you know . . . Five CMS RAC Open Door Forum facts

  • Patient Financial Services Weekly Advisor, Issue 14, April 17, 2009

    RACs receive the same contingency fee regardless of whether they identify over- or underpayments.

CMS updates RAC outreach schedule, FAQs

  • Patient Financial Services Weekly Advisor, Issue 14, April 17, 2009

    Get the updates on the RAC outreach schedule and FAQs from CMS.

CMS updates RAC outreach schedule, FAQs

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

    CMS has updated its RAC education and outreach schedule. The schedule contains new information...

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...

Did you know . . . Five CMS RAC Open Door Forum facts

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

    According to CMS, as noted in the April 14 Medicare RAC Special Open Door Forum, the following are...

New free tools and Revenue Cycle Institute updates

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

    If you haven’t visited the Revenue Cycle Institute Web site recently, now is a good time. In...

Tip: Find out how non-hospital providers can get the RAC education they need

  • Patient Financial Services Weekly Advisor, Issue 12, April 3, 2009

    It's time to get non-hospital providers the education they need regarding RACs.

Q&A: RACs and critical access hospitals

  • Patient Financial Services Weekly Advisor, Issue 12, April 3, 2009

    Will RACs come after critical access hospitals?

CMS announces RAC Open Door Forums

  • The RAC Report, Issue 7, April 2, 2009

    CMS will be holding two Special Open Door Forums on RACs for Part A and Part B providers in April...

Q&A: RACs and critical access hospitals

  • The RAC Report, Issue 7, April 2, 2009

    Q: How will the RAC audits affect critical access hospitals (CAH) seeing as they are paid on a per...

Tip: Find out how non-hospital providers can get the RAC education they

  • The RAC Report, Issue 7, April 2, 2009

    CMS has recently announced the first round of provider information and outreach sessions on RACs...

Share your RAC appeal experiences

  • The RAC Report, Issue 7, April 2, 2009

    If you’ve experienced RACs at your facility during the demonstration project, we want to hear...

And the winner is . . .

  • The RAC Report, Issue 7, April 2, 2009

    Thanks to all who participated in our contest! In the previous issue of The RAC Report, we featured...

CMS rescinds and replaces previous RAC transmittal

  • The RAC Report, Issue 6, March 19, 2009

    On March 6 CMS issued Transmittal 148 rescinding and replacing previous instruction regarding the...

Q&A: RACs and readmissions

  • The RAC Report, Issue 6, March 19, 2009

    Q: A provider does three different procedures in three different days. Is this acceptable? Are RACs...

Tip: Have clear documentation when sepsis or SIRS is POA

  • The RAC Report, Issue 6, March 19, 2009

    Never assume that sepsis is present on admission (POA). Sepsis or severe sepsis may be present on...

Test your RAC knowledge to win

  • The RAC Report, Issue 6, March 19, 2009

    Think you know everything there is to know about RACs? Test your knowledge and enter to win!

CMS releases new and updated RAC FAQs

  • The RAC Report, Issue 5, March 5, 2009

    CMS released six new and updated FAQs related to RACs on February 17, 20 and 27.

Tip: Look into the future

  • The RAC Report, Issue 5, March 5, 2009

    RACs cannot randomly select or target a claim “solely because it is a high-dollar...

Provider Q&A: Directing RAC correspondence

  • The RAC Report, Issue 5, March 5, 2009

    Q: How does a RAC denial notice come into your system? Does it go to the CFO or CEO, or to the...

Revenue Cycle Institute update

  • The RAC Report, Issue 5, March 5, 2009

    Have you visited the Revenue Cycle Institute Web site lately?

Trivia winner announced!

  • The RAC Report, Issue 5, March 5, 2009

    Find out the answers to the trivia questions we asked in the previous issue of The RAC Report.

Trivia: RAC your brain for a chance to win!

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

    Editor’s note: Answer all the questions correctly and submit your answer on or before...

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...

Tip: Tune in to RAC outreach sessions and town hall meetings

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

    The announcement from CMS officially kicks the RAC program back into gear. Hospitals and providers...

In case you haven't heard...

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

    CMS announced February 6 the permanent RAC program is once again underway as the RAC bid protests...

CMS Releases Updated RAC Expansion Schedule

  • HCPRO Website, Issue 1, February 10, 2009

    CMS has revised its RAC expansion schedule, according to the new "RAC Phase In Map"...

RAC Protest Resolved: CMS to Continue Implementation

  • HCPRO Website, Issue 4, February 6, 2009

    CMS announced February 6 the permanent RAC program is once again underway as the RAC bid protests...

Q&A: News on the permanent RAC program

  • The RAC Report, Issue 3, February 5, 2009

    Q: Is there any news on the new start-up date for the permanent RAC program? If not, when do we...

Tip: Address one-day stays before the RAC permanent program begins

  • The RAC Report, Issue 3, February 5, 2009

    It is no secret that RACs focused on one-day stays in the demonstration project. So what are you...

Help ensure RAC-friendly inpatient coding: The importance of discharge notes

  • The RAC Report, Issue 3, February 5, 2009

    Most inpatient coders are accustomed to seeing “probable,” “suspected,&rdquo...

Sample tools, e-mail news updates, and more

  • The RAC Report, Issue 3, February 5, 2009

    We’ve added several new features to our Revenue Cycle Institute Web site...

Did you know?

  • The RAC Report, Issue 2, January 22, 2009

    Did you know about the Revenue Cycle Institute blog? You’ll find tons of news, loads of tips...

Understand the intricacies of medical necessity

  • The RAC Report, Issue 2, January 22, 2009

    Medical necessity is complex because there is debate regarding what constitutes...

Q&A: RAC information for long term care facilities

  • The RAC Report, Issue 2, January 22, 2009

    Q: Most of the RAC information I have seen has been geared to the hospitals, and rightly so. But do...

Take note: 10 RAC facts to consider

  • The RAC Report, Issue 2, January 22, 2009

    Consider the following 10 RAC facts as you prepare for RACs to go live in your area.

RAC automated reviews

  • Patient Financial Services Weekly Advisor, Issue 104, January 9, 2009

    You need answers as the RAC nationwide project looms. Here’s one.

Q&A: RAC automated reviews

  • The RAC Report, Issue 11, January 8, 2009

    Q: Under what circumstances can a RAC make a finding that an overpayment or underpayment exists...

Tip: Hire a physician liaison to jump-start your RAC efforts

  • The RAC Report, Issue 11, January 8, 2009

    One item that appears to be missing from most HIM directors’ RAC preparation checklist is a...

Update: CMS releases updated RAC demonstration report

  • The RAC Report, Issue 11, January 8, 2009

    On January 6 CMS released an update to its three-year RAC demonstration program report previously...

Tip: Stay on top of common coding pitfalls

  • The RAC Report, Issue 10, December 24, 2008

    Although coding denials did not remain the focus by the end of the demonstration project, and...

Reader response: Don't forget Condition Code 44

  • The RAC Report, Issue 10, December 24, 2008

    By Barbara Aubry, RN, CPC, CHCQM, FAIHQ As mentioned in the previous issue of the RAC Report...

Revenue Cycle Institute releases updates to Revenue Cycle white papers

  • The RAC Report, Issue 10, December 24, 2008

    The Revenue Cycle Institute announces new and updated white papers available for download. In...

CMS updates: Contacting CMS in regards to RAC-reviewed claims and RAC ODF transcripts

  • The RAC Report, Issue 10, December 24, 2008

    Are you questioning a claim reviewed by a RAC during the demonstration project? If so, CMS...

Play a key role on your facility's RAC team

  • Patient Access Weekly Advisor, Issue 81, December 17, 2008

    Use the holiday season to provide a review session for all access registrars by reviewing a sample...

FAQ: CMS releases updated answers to RAC questions

  • The RAC Report, Issue 9, December 11, 2008

    CMS posted new and updated RAC FAQs on the CMS Web site on December 2.

Tip: Get physicians on board to lessen the effects of RACs

  • The RAC Report, Issue 9, December 11, 2008

    If documentation in the medical record is not accurate, complete and timely patient care can be...

CMS revises reporting form to distinguish between RAC and other appeals

  • The RAC Report, Issue 9, December 11, 2008

    In Transmittal 144, released November 28, CMS revised its Monthly Statistical Report on...

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...

Dig out your calculators: CMS announces RAC medical record request limitations

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

    On October 30, CMS announced limitations on the number of medical records RACs could request for...

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...

Scoop on HDI

  • The RAC Report, Issue 6, October 30, 2008

    You may want to know about this RAC contractor -- it had the most denials overturned on appeals...

Key differences in nationwide rollout

  • The RAC Report, Issue 6, October 30, 2008

    Vulnerability reporting; standardized base notification of overpayment letters to providers. Learn...

Q&A: Medical records request

  • The RAC Report, Issue 6, October 30, 2008

    Question: Under what circumstances can a RAC make a finding that an overpayment or underpayment...

Q&A: Critical Access Hospitals

  • Patient Access Weekly Advisor, Issue 74, October 29, 2008

    Question: Are Critical Access Hospitals safe from a RAC audit?

CHANGES COMING: Key differences in nationwide rollout

  • Patient Access Weekly Advisor, Issue 74, October 29, 2008

    Now that you know which Medicare Recovery Audit Contractor (RAC) will come to your facility...

Ask more questions with the MSP

  • Patient Access Weekly Advisor, Issue 73, October 22, 2008

    Speed? Accuracy? Those are important delivering the Medicare Secondary Payer Questionnaire, but if...

Q&A: Critical Access Hospitals

  • The RAC Report, Issue 5, October 16, 2008

    Question: Are Critical Access Hospitals safe from a RAC audit? Answer: No. Medicare auditors can...

Contingency fees announced

  • The RAC Report, Issue 5, October 16, 2008

    RACs get paid “contingency fees” based on the amount of the improper payments they...

CMS hires RAC Validation Contractor

  • The RAC Report, Issue 5, October 16, 2008

    The RAC Validation Contractor (RVC) will work with CMS and the RACs to approve new issues the RACs...

RAC UPDATE: Contingency fees announced

  • Patient Access Weekly Advisor, Issue 72, October 15, 2008

    CMS announced the new Medicare Recovery Audit Contractors (RACs) for its permanent nationwide...

CMS to publish edits in its Medically Unlikely Edit (MUE) program

  • The RAC Report, Issue 4, October 4, 2008

    CMS established the MUE program January 1, 2007, to ensure providers and suppliers do not report...

Q&A: RAC review

  • The RAC Report, Issue 4, October 2, 2008

    Question: If a provider has performed a self-audit prior to RAC review and wants to extrapolate...

Getting prepared

  • The RAC Report, Issue 4, October 2, 2008

    A comprehensive checklist to prepare you for a RAC visit.

CMS publishes new numbers on RAC demonstration project

  • The RAC Report, Issue 4, October 2, 2008

    Of the number of claims with overpayment determinations (525,133), providers have won 35,819 on...

Take-home hints on MSP

  • Patient Access Weekly Advisor, Issue 70, October 1, 2008

    Need hints on the MSP Questionnaire? We've got them.

What patient access managers should watch with RACs

  • Patient Access Weekly Advisor, Issue 70, October 1, 2008

    Check out these tips for patient access managers about preparing for a RAC visit. The manager...

Patient access managers must be ready for RACS

  • Patient Access Weekly Advisor, Issue 69, September 24, 2008

    “I strongly urge hospitals to take advantage of this lull in the RAC process to perform gap...

SPEAKING OF MSP: Tips to monitor staff members’ efficiency

  • Patient Access Weekly Advisor, Issue 69, September 24, 2008

    Check out these MSP tips provided by Stephanie Smithson, CHAM, patient access manager at Dunn...

TIP: Don't forget about MSPs in RACs

  • Patient Access Weekly Advisor, Issue 69, September 24, 2008

    Though CMS officially terminated the Medicare Recovery Audit Contractor Medicare Secondary Payer...

California Hospital Association questions CMS numbers from demonstration project

  • The RAC Report, Issue 3, September 18, 2008

    Regarding these concerns, Rep. Lois Capps, D-California, wrote a letter to Tim Hill, Office of...

Patient access managers chime in on RAC preparedness survey

  • Patient Access Weekly Advisor, Issue 68, September 17, 2008

    Are you and your peers in the revenue cycle fully prepared for the arrival of the Medicare Recovery...

NEWS: Revised timeline for RACs

  • Patient Access Weekly Advisor, Issue 68, September 17, 2008

    Demand letters from Medicare’s Recovery Audit Contractors (RACs) may be arriving in your...

What RACs are looking for

  • The RAC Report, Issue 2, September 4, 2008

    Nancy Hirschl, president of Hirschl and Associates in Laguna Niguel, CA, and a RAC Report Advisory...

Who should be on your organization's RAC task force?

  • The RAC Report, Issue 1, August 19, 2008

    Team members should represent all facets of the revenue cycle.

Get your appeals process ready

  • The RAC Report, Issue 1, August 19, 2008

    “You need to fight back or you’re going to have a target on your head,” says...

Things you need to know about RACs

  • The RAC Report, Issue 1, August 19, 2008

    The RACs corrected more than $1 billion of Medicare improper payments from 2005 through March 27...

GAO plans a review of RAC program

  • The RAC Report, Issue 1, August 19, 2008

    The Government Accountability Office plans to begin a review of the Medicare RAC program near the...