audits to provide oversight for the various regulatory and billing laws, rules, and OCC has also participated in numerous other audits where compliance was a peripheral …Read more
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with the Medicare conditions of participation and has a Report on Medicare Compliance. Copyright © 2008 by Atlantic Information Services, Inc. …Read more
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FRAUD, WASTE AND ABUSE COMPLIANCE POLICYThe Company has developed this Fraud, Waste and Abuse (”FWA”) Compliance Policy to be a Corporate Compliance Officer, the Medicare. Compliance Officer, the Corporate Compliance Committee and Internal Audit shall …Read more
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Medicare RAC Auditors are coming to your area. Will your practice be ready?
Medicare RAC Base Line Audit – What is RAC?
The RAC(s)-Recovery Audit Contract will pursue the identification of Medicare claims which contain non-MSP improper payments for which payment was made or should have been made under part A or B of title XVIII of the Social Security Act.
In 2006, Section 302 of the Tax Relief and Health Care Act made the Recovery Audit Contractor (RAC) program permanent. The program will be in place in all 50 states and Puerto Rico no later than 2010. The stated goal of the recovery audit program is to identify improper payments paid on claims to health care providers through Medicare beneficiaries. These may be either overpayments or underpayments. A demonstration program in California, Florida, and New York was deemed successful and as a result Congress made the RAC program permanent. The demonstration in those 6 states resulted in the return of over $900 million in overpayments to the Medicare Trust Fund between 2005 and 2008 while nearly $38 million in underpayments was returned to health care providers.
What does this mean to me?
Medical claims audits embody significant risk to revenues and profit margins for any healthcare provider. These audits typically include very complex appeals processes with stiff penalties such as the automatic recoupment of funds if appeals deadlines are not met. We can help you to prepare for RAC Audit.
Prepare your practice for the impending CMS RAC (Recovery Audit Contract). Anyone who files claims with Medicare will be audited, starting no later than January of 2010. This includes physicians, hospitals, home health agencies, and Durable Medical Equipment providers.
Waiting for Medicare to audit you can prove costly if you do not know where your billing and coding may be improper. The RACs are compensated on a contingency basis, so you can be sure they will be aggressive in their audits. Any overpayments found by the RACs will need to be reimbursed to Medicare, which can collect their reimbursement from any future claims checks owed to you. It is possible RAC auditors could impose stiff fines of up to $10,000 for each infraction.
Medical claims audits embody significant risk to revenues and profit margins for any healthcare provider. These audits typically include very complex appeals processes with stiff penalties such as the automatic recoupment of funds if appeals deadlines are not met. We can help you to prepare for RAC Audit.
CMS RAC Program: Are You a Target?
Anyone who files claims with Medicare will be audited, to start no later than January of 2010. This includes physicians, hospitals, home health agencies, and Durable Medical Equipment providers.
So why should I use your service for a baseline audit prior to being audited by the RAC?
By using a third-party audit in advance, your practice can identify improper billing and coding practices and take necessary corrective actions prior to the RAC audit. This can help you save both time and money. In addition, you may find areas in which you are being under reimbursed as well. The audit works both ways. If you have been underpaid due to incorrect coding, etc. then you may collect that amount.
Our process is easy and turnaround time is quick. We will provide you with a base line audit of your billing and coding. Our audits are performed by certified coders who have extensive experience doing government audits. After receiving the information we need from you, a report will be delivered approximately one week later. We will go over that report and help identify and make suggestions as to areas for improvement.
Prepare your practice for the impending CMS RAC (Recovery Audit Contract). Our team will provide a base-line audit on your documentation and billing practices. Our report will allow you time to make any changes in your current practices.
How do I schedule a Medicare RAC Baseline Audit with your company?
Call toll free (800) 813-3740 x 1 today to prepare for RAC Audit and have peace of mind. Waiting for CMS RAC to audit can prove you costly. The RACs are compensated on a contingency basis, so they are very aggressive in their audits. These audits typically include very complex appeals processes with stiff penalties such as the automatic recoupment of funds if appeals deadlines are not met. We will sail you smoothly through the whole RAC process.
How much does the Medicare baseline audit service cost?
Our service cost only $995 per Audit and will be completed in a few days. It is not worth the risk to your practice to wait for Medicare RAC Auditors to find mistakes in your billing practices.
- We perform a 50 patient chart random base-line audit
- Done by certified coding auditors
- Evaluation & Management (E&M) done by specialty
- Review of documentation compliance rules for all levels of service
- Evaluation of diagnosis coding
- Coding evaluation by Specialties
- Medical necessity expertise
- in 7-10 days you will receive a detailed compliance summary on our findings with recommendations to bring your documentation into Medicare compliance immediately
- It will allow your practice time to make changes before Medicare Auditors come to your door.
Our team will provide a base-line audit on your documentation and billing practices. Our report will allow you time to make any needed changes in your current practices billing and coding procedures.
Visit www.PaymentAutomation.net or call toll free (800) 813-3740 x 1
