Medicare Recovery Audit Contractor (RAC) - 12/07/2016

Recovery Audit Contractors, which are required under the Tax Relief and Health Care Act of 2006, are tasked with detecting and correcting past improper Medicare payments.

Your Options Following a Recovery Audit Overpayment Determination - 06/03/2016

The Medicare Recovery Audit Contractor (RAC) program is designed to ferret out incorrect payments to physicians, hospitals, and other health care professionals. An appeal to a RAC determination of overpayment is essentially the same as any other Medicare appeal. However, a RAC initial determination is not appealed to the RAC - rather it is appealed to the Medicare carrier, i.e., to TrailBlazer for Texas physicians.

Received a RAC Records Request or Repayment Letter? - 06/03/2016

Texas practices are hearing from Connolly, Inc., the Medicare Recovery Audit Contractor (RAC) for Texas. Be sure to check the validity of any records requests you receive, and weigh your options when responding to a repayment letter.

Be Proactive in Preparing for Audits - 06/03/2016

All practices that submit claims to government programs are likely at some point to experience a Medicare Recovery Audit Contractor audit.  If you have not yet prepared for a possible audit, now is the time to get ready and have a plan in place.

New Patient Visit: Three Years Is a Key - 06/03/2016

Centers for Medicare & Medicaid Services auditors have identified claims coded for “new patient” evaluation and management services that don’t fit the definition for new patient services. Be sure to avoid this coding error.

Use Correct Surgery Modifiers in Medicare Claims - 05/13/2016

Medicare auditors working under the Recovery Audit program have identified significant payment errors related to surgery. Be sure to bill correctly using these modifiers.

How to Respond to a Medicare Audit - 05/13/2016

TMA Practice E-Tips editors ran across this excellent checklist of “17 tips from a lawyer” on how to respond to a Medicare audit.