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ED NOTE: The recent CMS Special Open Door Forum for Part A providers conducted by CMS as an audio conference call is being reported by Ernie de los Santos in the second and final installment in two-part series. Part II: CMS describes the difference with M...
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REPORTING FROM HCCA IN LAS VEGAS
CARLA ENGLE, MBA
Monday, 04/27/09
Monday proved to have many great sessions that continued the Medicare/Medicaid benefit integrity education. Daniel Levinson, the Inspector General of HHS, started the morning...
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By: Nancy J. Beckley, MS, MBA, CHC
The Recovery Audit Contractor (RAC) Program is beginning its rollout in Yellow and Green States. A feature of the RAC Program in its permanent state is the explicit promise of Provider Outreach Sessions. In fact, the...
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By Ernie de los Santos
DALLAS (April 21, 2009)--- Much like their forefathers would have done, scanning the vast Texas sky for the telltale signs of a gathering storm, providers in the Lone Star state are making plans to hunker down and ride out whatever...
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Providers will be under a great deal more examination and scrutiny from Medicare and Medicaid auditing bodies that are scouring for evidence of improperly paid claims as well as fraud and abuse, reports Carla Engle, MBA, in this Thursday's edition of RACM...
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By Ronald S. Connelly, Principal
Powers Pyles Sutter & Verville PC
In the first case of its kind, the powers of Recovery Audit Contractors and Administrative Law Judges regarding the reopening of hospital claims are central issues in a complaint...
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By Patricia Dear
Indentifying status correctly is not necessarily easy.
It is difficult to get this process right. And it is extremely important to get the status correct and documented sufficiently, in order to protect reimbursements from RAC (an...
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By Megan Jones
News that Part A & B data has started flowing to the RACs was probably the most pertinent information delivered last week when approximately 150 people attended the first CMS/RAC Region A Outreach meeting hosted by the Greater New York...
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By Cheryl E. Servais, MPH, RHIA
VP, Compliance and Privacy Officer
With some providers reporting that they were receiving requests for hundreds of records at once from the RACs, CMS has placed limits on the number of records that a RAC can request.
CMS...
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Would you believe 100 percent recoupment?Hospital admission Status Designation is the bane of reimbursement for many hospitals and will be a focus area for RACs.
Payers and review organizations, including the RACs, deny claims for insufficient documentat...
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It only stands to reason that medical necessity would be an enticing target for RACs - the demonstration yielded $391 million in recovered payments, or 40 percent of $930 million in collected overpayments, according to the CMS RAC Status Document for FY 2...
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FROM THE PUBLISHER
While leaders of the Group of 20 continue their London Summit today to discuss the current global economic crisis, members of the Michigan Health & Hospital Association are settling in for an economic summit of another kind - the R...
