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Recovery Auditor Report

The Recovery Auditor Report is a free biweekly e-newsletter of useful tips and strategies to get you prepared for the arrival of Medicare's Recovery Audit Contractors (RACs).

2012 | 2011 | 2010 | 2009 | 2008

Issue 24, November 29, 2012

• Notice: Your subscription will be changing in the coming weeks!

  Very shortly, Recovery Audit Report will be replaced with Medicare Insider.

• OIG issues review of Medicare appeals at the Administrative Law Judge level

  On November 15, the OIG issued a review of ALJ appeals decided in fiscal year 2010.

• Recent Recovery Auditor activity

  Connolly posts 24 new issues across five categories

• Roundup: Relevant Medicare updates

  CMS issues notice on hospital outpatient payment panel

Issue 23, November 15, 2012

• Recovery Auditors on the hot seat: Scrutiny pouring in from numerous angles

  On October 16, it was reported that legislation was introduced by Representative Sam Graves (R-MO...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor Activity

  HealthDataInsights posts four new issues across two categories

• Final OPPS rule increases drug payments

  The 2013 Outpatient Prospective Payment System final rule finalizes ambulatory payment...

Issue 22, November 1, 2012

• Recovery Auditor improvements, transparency highlight house legislation bill

  Representative Sam Graves (R-MO) introduced legislation October 16 that aims to improve the...

• Prepayment review demonstration begins; CDI role in audit defense gains momentum

  Editor’s note: This article originally appeared in the CDI Journal.

• Recent Recovery Auditor Activity

  Performant Recovery posts three issues across two categories  

• Readmissions Reduction: A 360-Degree Review

  Hospital readmissions have the potential to cause a negative financial impact on your facility and...

Issue 21, October 18, 2012

• CMS issues next wave of supervision decisions on Hospital Outpatient Payment Panel

  Earlier this year, CMS held its first Hospital Outpatient Payment Panel meeting, which managed to...

• HHS Secretary Kathleen Sebelius interview with BC Advantage

  BC Advantage—a company that provides medical office with in-depth content written by industry...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor activity

  HealthDataInsights posts two new issues across two categories, including first prepayment review...

• Reboot for ICD-10 - Lessons from UnitedHealth Group

  The transition to ICD-10 code set is expected to be one of the most substantial changes in medical...

• Reboot for ICD-10?Training and Operational Readiness Checklist for 2013

  Webcast: Oct. 22, 2012, 1:00-2:30 p.m. ET

Issue 20, October 4, 2012

• CMS releases latest Recovery Auditor improper payment figures

  Following the close of each fiscal year (FY) quarter, CMS releases statistics for the amount of...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• HCPro's 2012 Medicare Compliance Forum

  HCPro and the Revenue Cycle Institute team are proud to announce the 2012 Medicare Compliance Forum

• Recent Recovery Auditor activity

  DCS issues important provider notice

Issue 19, September 20, 2012

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor activity

  DCS Healthcare posts new issue for inpatient hospital claims

Issue 18, September 6, 2012

• CMS releases October OPPS update

  CMS released the October OPPS update this week with a smattering of unrelated, but important...

• Recovery Auditor prepayment review ODF transcript and audio

  The transcript & audio file from the August 9, 2012 Medicare Fee-For-Service Recovery Auditor...

• Medicare Compliance Forum 2012 spotlight: CMS' proposal to redefine inpatient

  In the recently released 2013 OPPS proposed rule, CMS issued a request for comments that suggests...

• CMS finalizes ICD-10 compliance date

  HHS will delay implementation of ICD-10 by one year, from October 1, 2013 to October 1, 2014.

• Recent Recovery Auditor activity

  DCS Healthcare posts new issue for outpatient hospital claims

Issue 17, August 23, 2012

• Financial impacts of the Hospital Readmissions Reduction Program

  Last week, Kimberly posted an overview of the FY 2013 IPPS final rule and the potential impact to a...

• Recent Recovery Auditor Activity

  Connolly posts 10 new issues across three categories

Issue 15, August 9, 2012

• CMS announces official start date for Recovery Auditor prepayment reviews

  CMS officially announced the Recovery Auditor prepayment review demonstration this past November...

• CMS releases 2013 IPPS final rule

  On August 1, CMS issued a display copy of the 2013 inpatient prospective payment system final rule.

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

Issue 14, July 26, 2012

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor activity

  CGI posts four new issues for physician claims

• Recent Recovery Auditor activity

  DCS Healthcare posts seven new issues across four categories

Issue 13, July 12, 2012

• CMS issues 2013 OPPS proposed rule

  CMS is proposing two major changes as part of the 2013 Outpatient Prospective Payment System (OPPS...

• Three-day payment window FAQs issued by CMS

  On June 14, CMS issued 43 new FAQs related to MLN Matters article MM7502, “Bundling of...

• CMS replaces transmittal on reporting of recoupment for overpayment on the RA

  On June 28, CMS replaced transmittal R1088OTN, containing information on the reporting of...

• Recent Recovery Auditor activity

  CGI posts new issue for outpatient claims

Issue 12, June 28, 2012

• Coming soon: Recovery auditor prepayment reviews

  Last November, CMS unveiled three demonstration projects aimed at reducing improper payments in the...

• July OPPS update: Self-administered drugs

  Last week, Kimberly provided an overview of the many significant updates and clarifications that...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor activity

  HealthDataInsights posts seven new issues across three categories

Issue 11, June 14, 2012

• First of 2012: CMS announces supervision decisions for select services

  In the 2012 outpatient prospective payment system (OPPS) final rule, CMS established a process to...

• Recent Recovery Auditor Activity

  DCS Healthcare posts ten new issues across six categories

• Note from the instructor: July 2012 quarterly update contains multiple significant updates and clarifications

  There were a number of interesting items in the July 2012 Update to the Hospital Outpatient...

Issue 10, May 31, 2012

• CMS identifies CERT, Recovery Auditor findings in latest quarterly compliance newsletter

  Last month CMS released the seventh issue of its Medicare Quarterly Provider Compliance Newsletter.

Issue 9, May 17, 2012

• Recent OIG reports show critique on CMS' processes and programs

  During the past few months, there have been a number of Office of Inspector General (OIG) reports...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent Recovery Auditor activity

  DCS Healthcare posts one new issue into two categories

• Medicare rules change frequently

  With a year subscription to the Medicare Boot Camp for Hospitals Quarterly Update Service, you will...

Issue 8, May 3, 2012

• CMS issues IPPS proposed rule for FY2013

  Inpatient acute care hospitals could see a 2.3% increase in payment rates under the fiscal year...

• Recent Recovery Auditor Activity

  CGI posts new issue for medical necessity claims  

• 2012 broadcast events program calendar

  Take a look at all of the different programs that HCPro has to offer this year in its 2012...

• HCPro's 2012 Medicare Compliance Forum

  HCPro and the Revenue Cycle Institute team are proud to announce the 2012 Medicare Compliance Forum.

Issue 7, April 19, 2012

• Recovery auditor hot topics: Audit MICs struggling to identify overpayments

  On March 20, the Office of Inspector General (OIG) issued a report that presents an early...

• New! Revenue Cycle Institute releases 2012 Three-Day Rule White Paper

  The Revenue Cycle Institute has released a new white paper, “Mastering the Three-Day Payment...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• One-year delay of ICD-10-CM/PCS proposed from HHS

  HHS released a proposed rule yesterday that announces a one-year delay for the implementation of...

• Recent Recovery Auditor activity

  DCS Healthcare posts eight new issues across four categories

Issue 6, April 5, 2012

• CMS to resolve incorrect claims processing issue for 12X and 13X bill types

  On February 24, CMS sent out an update informing providers that it has identified a Medicare claims...

• CMS requires the creation of improper payment edits

  In early March, CMS released two related transmittals that rescinded prior transmittals.

• Recent Recovery Auditor activity

  DCS Healthcare posts three new issues across two categories

• Three-day payment window explained

  Join HCPro on Tuesday, April 17, at 1 p.m. (Eastern) for the 90-minute live audio conference...

Issue 5, March 22, 2012

• Recovery auditor hot topics: Medicaid RACs

  The following article is part two in a series covering various topics in the world of recovery...

• Recovery Auditors to increase medical records request limits

  On March 12, CMS issued an update that effectively raises the additional documentation requests...

• From the field: CMS Q&A on the discussion period

  After reading about another provider’s Recovery Auditor correspondence woes in a February 23...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent recovery auditor activity

  CGI posts three new issues across two categories

Issue 4, March 8, 2012

• Recovery auditor hot topics: esMD

  The following article is part one in a series covering various topics in the world of recovery...

• Q&A with Debbie Mackaman: Recovery auditors and more

  What type of impact do you think the newly announced demonstration project for recovery auditor...

• Recent recovery auditor activity

  HealthDataInsights posts 10 new issues for medical necessity claims

Issue 3, February 9, 2012

• Start date announced for recovery audit prepayment review demo

  On November 15, 2011, CMS unveiled three demonstration projects aimed at reducing improper payments...

• CMS posts year-end improper payment figures, top issues by region

  On February 9, CMS posted its latest recovery auditor update. The results show a continuing trend...

• Recovery audits result in changes to CMS systems and recoupment options

  This week CMS published two transmittals that affect CMS systems as a result of the recovery audit...

• New! Revenue Cycle Institute releases 2011 Recovery Auditor Benchmarking Report

  The Revenue Cycle Institute has released a new white paper

• Recent recovery auditor activity

  Connolly adds 17 new issues across five categories

• From the field: Recovery auditor correspondence troubles

  A provider in Region C has recently experienced problems with Connolly (The Region C recovery...

• Medicare Membership Program

  Get answers to your questions and Medicare compliance guidance from the experts all year long.

• Recent recovery auditor activity

  DCS Healthcare posts new issue for DME supplier claims

Issue 2, January 26, 2012

• CMS posts Q4 improper payment figures, top issues by region

  Each quarter CMS issues a recovery audit program update that details the total amount of...

• CMS posts new quarterly provider compliance newsletter

  In its most recent (January 20) Medicare Quarterly Provider Compliance Newsletter, CMS once again...

• From the field: The demand letter problem grows

  A RAC coordinator at a hospital in Region B (who wished to remain anonymous) shared one of her...

• Recent RAC activity

  DCS Healthcare posts 25 new issues for medical necessity claims

Issue 1, January 12, 2012

• CMS to delay two of out three new demonstration projects aimed at reducing improper payments

  On December 29, CMS issued a notice announcing the delay of the recovery audit prepayment review...

• From the field: Chasing clues on demand letters

  A RAC coordinator at a hospital in Region C (who wished to remain anonymous) shared one of her...

• Revenue Cycle Institute posts free monthly tool

  Each month the Revenue Cycle Institute publishes a free sample tool or form for readers.

• Recent RAC activity

  DCS Healthcare posts 40 new issues for medical necessity claims

Issue 10, May 31, 2012

• Note from the instructor: CMS to release new short-term acute care PEPPER

  In late May, CMS plans to release nationwide a new short-term (ST) acute care Program for...

• Recent Recovery Auditor Activity

  Connolly posts 12 new issues across five categories