HOME / Featured News / NEWS FROM THE FEDS
Medicare Audits, the Basics
Rate This Article:
0
At its web site HERE, Trailblazer Health Enterprises reports that "the CMS Recovery Audit Contractor (RAC) program is now permanent and has officially arrived in Colorado, New Mexico, Oklahoma and Texas. For those who are not familiar with the goal of the RAC, it is a comprehensive effort to identify improper Medicare payments and fight fraud, waste and abuse, which protects the Medicare trust fund for taxpayers and future Medicare beneficiaries. (Improper payments may be overpayments or underpayments.)
 
Medicare providers can prepare for RAC audits by establishing efficient and appropriate internal office operations. Below are key suggestions:
 
  • On a weekly basis, check the approved issues on Connolly Healthcare’s Web site. This action will allow providers and their RAC coordinators the opportunity to view them first-hand. Internal audits are encouraged based on the issues that pertain to their specific services.     http://www.connollyhealthcare.com/RAC/pages/approved_issues.aspx
  • Designate a RAC coordinator in the office with the responsibility of responding to RAC record requests, meeting RAC deadlines and managing the appeals process.
  • Be aware of the design and look of the Connolly Healthcare envelope. Convey this information to all personnel who manage and distribute the mail, while emphasizing the requests are to be handled timely.
  • Establish a tracking system for all RAC-related records requests, deadlines and responses. (RAC DUE DATE: 45 days from the date of the medical record request letter.)
  • If a question arises, call Connolly Healthcare directly at (866) 360-2507 or toll free at (203) 529-2315. (The Provider Contact Centers (PCCs) answer general questions only.) 
Additional information about the types of RAC reviews and time limits, and an example of the Connolly Healthcare envelope can be found in the Partners in Compliance training manual at: 
 
 
Post A Comment
* Indicates Required Field
Comment Title:
* Comments:
Nickname:
* Validation:
Most Recent Comments
 
 
FeaturedNews
OIG: Feds Don't Know Who's Opted Out of Medicare
Published 02/09/2012 - 5:46 a.m.  CDT

Medicare and its contractors don't adequately track which physicians are opting out of Medicare, making it nearly impossible to determine who is cutting ties with the program and why, according to a memo from the Department of Health and Human Services' Office of the Inspector General (OIG).
...Read More
Docs Urge Feds to Regulate 'Toxic' Sugar
Published 02/08/2012 - 6:25 a.m.  CDT

Added sugars are as much a threat to public health as alcohol and tobacco, and should be regulated in a similar fashion, some researchers suggest. That includes levying taxes on sugary foods and even enforcing age limits for buying sodas" researchers suggest.
...Read More
Drug wholesaler & pharmacies License Suspended by DEA
Published 02/07/2012 - 6:29 a.m.  CDT

Federal authorities have charged a major health care company and two CVS pharmacies in Florida with violating their licenses to sell powerful pain pills and other drugs.

The DEA suspended Cardinal Health's controlled substances licenses on Friday for the third time in five years. The Drug Enforcement Administration linked Cardinal Health to unusually high shipments of the controlled drugs to four pharmacies.  A federal judge temporarily halted the suspension the same day after Cardinal, a $1.3 billion company, said it would stop supplying the drugs to the four pharmacies.

The DEA alleges that Cardinal knew or should have known that the four retail pharmacies had purchased far more drugs than it needed to fulfill legitimate prescriptions.

...Read More
Reader Login
Username:
Password:
 Save Login?
Free Sign-up
Forgot Password?
Reader Control Panel
Article Popularity
Views
Ratings
Comments

Three months of rehabilitation with manual mobilization can attenuate thoracic kyphosis in elderly patients with osteoporosis.

TCA District 5 asks the question: "Have you ever wanted to get more involved and give back to your colleagues and the Chiropractic Profession? Now is your chance! We are looking for hardworking and passionate DCs to join the TCA District 5 Leadership!"

"This is your chance to be a part of the BIGGEST development of Chiropractic in Texas! Help us make history and preserve our practices for future generations. 2012 is about improving and redefining how Texans understand Chiropractic.

TCA District 5 will have an official vote on February 21st, 2012 at the Quarterly Meeting.

Find more information about TCA District 5's elections in this article.

Any alcohol consumption during pregnancy -- especially during the second half of the first trimester -- puts the newborn at risk for fetal alcohol syndrome (FAS), results of a study showed.

Medicare and its contractors don't adequately track which physicians are opting out of Medicare, making it nearly impossible to determine who is cutting ties with the program and why, according to a memo from the Department of Health and Human Services' Office of the Inspector General (OIG).

Did you know that the man in charge of the entire U.S. Olympic training facility and program is a Doctor of Chiropractic?

He is, and Dr Bill Moreau is coming to the TCA District 5 meeting on February 21, 2012.

Virtual reality exercise games, like the Wii Fit, may help older adults fight cognitive decline, researchers found.

If the Supreme Court rules that the Affordable Care Act's individual mandate is unconstitutional, the entire law doesn't need to be thrown out, lawyers for the Obama administration argued in a brief filed with the high court.

Added sugars are as much a threat to public health as alcohol and tobacco, and should be regulated in a similar fashion, some researchers suggest. That includes levying taxes on sugary foods and even enforcing age limits for buying sodas" researchers suggest.

Parker University held the Starlight Soirée, the premier chiropractic research event, on Friday, January 20, during Parker Seminars Las Vegas. The event raised nearly $33,000 for chiropractic research.

More than 100 headphone-wearing American pedestrians have been struck by trains, cars, or other vehicles since 2004, highlighting the danger pedestrians face when they shut their ears to the world, researchers said.