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.
Related Products
-
Core Skills for Hospital Case Managers:
A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...
-
Combat RAC Denials: Strategies for Successful Appeals
During this 90-minute audio conference, our speakers provide step-by-step procedures, timelines, tools, and best practices...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Level of Care Determinations for 2014: Las Vegas, NV
Attend the half-day seminar, Outpatient, Observation or Inpatient? Continuing to Walk the Tightrope of Regulatory Guidance...
-
OPPS and IPPS Reimbursement Fundamentals: Las Vegas, NV
Attend OPPS and IPPS Reimbursement Fundamentals, a half-day seminar on October 2nd in Las Vegas. Learn how CMS’ substantial...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Practice the six rights of medication administration
- Diagnostic v. screening mammogram based on referring physician’s order
- Note similarities and differences between HCPCS, CPT® codes
- Q&A: Primary, principal, and secondary diagnoses
- What to include on the incident report
- OB services: Coding inside and outside of the package
- What does case-mix index mean to you?
- Pneumonia with a negative chest x-ray: Clinical diagnoses, physician documentation, and coding guidelines
- CDC: First Case of Wuhan Coronavirus Confirmed in U.S.
- E-mailed
-
- CDC: First Case of Wuhan Coronavirus Confirmed in U.S.
- Neurological checks for head injuries
- Know the medical gas cylinder storage requirements
- Ask yourself: Could your CDI program work at home?
- Know guidelines and subtle differences in code descriptions for laceration repairs
- Joint Commission now allows partially-used oxygen canisters in 'full' rack
- Joint Commission addresses nurse burnout
- Documentation challenges for skin and dermatology coding
- Do not use pathology measurements to report a lesion's size
- Diagnostic v. screening mammogram based on referring physician’s order
- Searched
