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RAC Resource Bundle: Tips, Strategies and Need-To-Know Information for 2010 National Implementation
Managed Care Information Center, Dec 2009
3 Targeted Resources :
Preparing for a Medicare RAC Audit: How to Proactively Develop a Defense and Appeal Strategy to Minimize Losses - 90 minute program on CD-Rom
Identifying Top Reimbursement Compliance Issues in 2008: Preparing for OIG, Medicare Contractor and RAC Audits - 2 hour program on CD-Rom
RAC: A Strategy Guide to Protecting Medicare Claims Payments - 30 page special report
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 breifing 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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