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  • RAC Implementation Creating a Healthcare Vortex

    Created: 2009-06-24 06:13:15 Author: Patricia Dear, RN
    By: Patricia Dear   A ‘vortex,' as defined by Webster's, is a "fluid flow involving rotation...(a) whirlpool; a situation regarded as drawing into its center all that surrounds it."   Since the RAC demonstration (2005-08) proved wildly successful ...

  • RACs’ Strengths and Weaknesses Versus Providers: Who’s Winning at Mid-Year?

    Created: 2009-06-24 05:31:08 Author: Bret Bissey, MBA, FACHE, CHC
    By: Bret S. Bissey, FACHE, MBA, CHC As the summer quickly approaches, it might be a good time to assess what we have learned about the RAC efforts to date. I'd like to suggest we analyze RAC and provider efforts at mid-year 2009 via an evaluation fr...

  • RAC of Delay of Complex Reviews Good News or Bad?

    Created: 2009-06-03 20:21:10 Author: Ernie De Los Santos
    By Ernie de los Santos In an article released on Thursday, May 28, the AMA reported that CMS does not expect their RACs to conduct complex reviews for medical necessity of hospital services until 2010. ...

  • The RAC “Freeze” on Medical Necessity Reviews

    Created: 2009-06-03 19:59:20 Author: Dennis Jones
    By Dennis Jones On Thursday, May 28, the AHA News Web site broke the following bit of happy news: "The Centers for Medicare & Medicaid Services does not expect its Medicare recovery audit contractors to conduct complex reviews for medical necessi...

  • False Sense of Relief Could Spell Trouble with RACs

    Created: 2009-06-03 19:54:20 Author: Cheryl E. Servais, MPH, RHIA
    By Cheryl E. Servais, MPH, RHIA VP, Compliance and Privacy Officer The medical necessity review delay is like waiting for the other shoe to drop. While providers may feel a sense of relief in the delay of the RACs' medical necessity reviews, that fe...

  • RAC Delay Can Mean Denial

    Created: 2009-06-03 19:48:52 Author: Carla Engle, MBA
    By Carla Engle, MBA You all may have heard the adage "delay doesn't mean denial," which is true in many life circumstances. Unfortunately, in the world of RACs, delay can mean denial: denials of claims that translate to cash lost. Now, while you may be ...

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