RAC
Resource Bundle:
Tips, Strategies and Need-To-Know
Information for 2010 National Implementation
As the
healthcare world
awaits
the startling
Recovery Audit Contractor (RAC) recoupment amounts for 2009 to come in,
2008's $1 billion is not exactly easily forgotten; especially when the
assigned RACs called the billion in overpayments a 0.3 percent tip of
the iceberg for what national implementation can rake in.
Providers across the country are dreading the new year as 2010 kicks
off with all Medicare providers enrolling in the RAC program. Is your
organization prepared for its claims to be subjected to a fine tooth
comb?
Are you
aware of all the
possible defenses and the
post-denial
appeal process?
Have
you set up your
reserve fund?
Before your organization receives its demand letter from your region's
contractor, learn how to defeat RACs' selection process and protect
already paid Medicare claims through Healthcare Reimbursement
Monitor's RAC
Resource Bundle, comprised of two important briefing
programs on CD-Rom and a special report.
When CMS' advice for being prepared for RACs is to set up a reserve
fund, a portion of Medicare payments to pay-back CMS for a RAC
identified overpayment, it's not a matter of will your organization be
safe from recoupments, but a question of how much will be re-claimed.
Estimated Medicare overpayments exceed $10 billion annually, according
to CMS figures from 2001. Based on these estimates, the nationwide RAC
program creates a significant potential cost liability for healthcare
providers who are forced to turn over all challenged payments
immediately, and can only get them back after moving through the
appeals process.
Because RACs are paid on a contingency fee basis, receiving a
percentage of the improper payments they collect from providers, they
are highly motivated to find errors. The program has been criticized at
length by hospitals and members of Congress for being a
“bounty hunter” initiative.
The
RAC Resource
Bundle will help guide your organization through the
multiple
defenses and strategies that can be employed to ensure safety of past
Medicare claims.
The bundle includes:
two
programs on
CD-Rom -- “Preparing for a Medicare RAC Audit: How to
Proactively Develop a Defense and Appeal Strategy to Minimize
Losses,” and “Identifying Top Reimbursement
Compliance Issues in 2008: Preparing for OIG, Medicare Contractor and
RAC Audits,” and a special 30-page report
“RAC: A Strategy Guide to Protecting Medicare Claims
Payments."
Preparing
for a Medicare RAC
Audit: How to Proactively Develop a
Defense and Appeal Strategy to Minimize Losses -
The Centers for
Medicare and Medicaid Services (CMS) reported that Medicare has
recovered more than $1 billion through the RAC program since
2005, with 85 percent of the recovered improper
overpayments collected from inpatient hospitals. CMS is required by law
to make RAC a permanent, national program by Jan. 1, 2010. Three
diverse RAC experts
discuss these issues on the CD-Rom that includes usefule slides and
materials.
Identifying
Top Reimbursement
Compliance Issues in
2008: Preparing For OIG, Medicare Contractor, and RAC Audits
- The 2008
Office of the Inspector
General's (OIG) work plan
provides a list of areas considered subject to abuse, and therefore,
increased scrutiny. The RAC demonstration
program was slated to end this month, but the Tax Relief and Health
Care Act of 2006 has made the RAC program permanent. Identify the
coding, billing and reimbursement
compliance issues identified by RAC audits and the OIG FY2008 Work Plan
in this 2-hour audio and slides program on CD-Rom featuring well known
management consultant Dwayne Abby.
RAC: A
Strategy Guide to Protecting Medicare
Claims Payments - Approaching the deadline for
2010
national RAC
implementation, the editors of
Healthcare Reimbursement Monitor have compiled an in-depth
timeline of the RAC program and information on how to protect funds
through data collection and appeals. The focus of this 30-page report
is not only how to defend at risk claims from denial, but instituting
prevention tactics that will insure future financial safety.
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