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  • CBCs and CERT Review: Steps to Avoid Improper Payments in 2010

    Created: Wednesday, 20 January 2010 18:33 Author: Randy Wiitala, BS, MT (ASCP)
    As 2009 ended, we noted that CERT auditors nationwide were stepping up their efforts to improve provider compliance with Complete Blood Count (CBC) coding and billing guidelines. ...

  • Picture Yourself at the Post Office – The Government Just Might Accommodate!

    Created: Wednesday, 20 January 2010 18:03 Author: Nancy J. Beckley, MB, MBA, CHC
    Providers in Florida have gotten used to all the jokes about our fine state, and in particular the one about the city of Miami being the epicenter, or ground zero, of Medicare fraud (cue up "Conga" with Gloria Estefan and the Miami Sound Machine). ...

  • Controller Takes Action and Forms RAC Team

    Created: Wednesday, 20 January 2010 00:00 Author: Cheryl E. Servais, MPH, RHIA
    We all know that the RACs are here, but what should we be doing to be in the best position to minimize the stress that their audits could cause? To answer that question, I spoke with Ted Anderson, FHFMA, CPA, who is the Controller for Highlands Regional ...

  • Region D RAC Posts 530 Issues for Complex Review

    Created: Thursday, 07 January 2010 00:00 Author: Chuck Buck
    530 MS-DRGs Now Approved for DRG Validation and MS-DRG Coding Review   (January 8, 2010)---Health Data Insights (HDI) has posted 66 new approved issues for review on their Web site. The posting took place late Wednesday, January 6. HDI is the CMS Re...

  • Will the RACs Audit Critical Access Hospitals?

    Created: Wednesday, 06 January 2010 16:03 Author: Duane Abbey, PhD, CFP
    Critical Access Hospitals (CAHs) are different - well, at least for Medicare. Prospective payment systems like APCs and MS-DRGs are not used by CAHs. So does this mean that the RACs will not be interested in CAHs? With a moment's reflection you will pro...

  • Winter Is Heating Up: Complex Reviews Are Here!

    Created: Tuesday, 05 January 2010 15:43 Author: Carla Engle, MBA
    Santa was not the only one delivering gifts this holiday season.   Just before most of you started taking some well-deserved time off in late December, reports of the first sets of complex medical record documentation requests from Connolly Healthcare ...

  • RACs to Providers: Happy New Year, and Game On!

    Created: Monday, 04 January 2010 22:35 Author: Patricia Dear, RN
      We heard recently that the RACs submitted over 90 issues for CMS aproval, to begin their audits of provider claims going back to October 1, 2007. Before a RAC can officially conduct an audit for any issue, they must have it approved by CMS, and the is...

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