Medicare and Medicaid RAC Audits: How Auditors Get It Wrong

Monday, March 12, 2018
Trending Topic Broadcast
10-10:30 a.m. EST; 7-7:30 a.m. PST

Knicole Emanuel, Esq., Partner,
Potomac Law Group, PLLC

Nancy Beckley, MS, MBA, CHC; David Glaser, Esq.;
Ronald Hirsch, MD, FACP, CHCQM;
Kristi Pollard, RHIT, CCS, CPC, CIRCC, AHIMA-approved ICD-10-CM/PCS trainer
and Timothy Powell, CPA


RACmonitor was founded in 2008 to provide news and information for healthcare providers on the emergence of the government’s Recovery Audit Contractor (RAC) program. From a Centers for Medicare & Medicaid Services (CMS) demonstration in that year, and continuing to the national rollout in 2010 (coincidentally, the year of Monitor Mondays’ national debut), we have been reporting on activities not only of the RACs, but also the Medicare Administrative Contractors (MACs), Zone Program Integrity Contractors (ZPICs), and the Quality Improvement Organizations (QIOs).

But why, after nearly 10 years, do these auditors still tend to get auditing wrong? Providing insight into this issue during the next edition of Monitor Mondays will be healthcare attorney Knicole Emanuel, a partner in the Potomac Law Group, who will be the broadcast’s special guest.

The broadcast rundown also will include:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, will be making his Monday Rounds with another installment of his popular segment.

  • Hot Topics: Monitor Mondays senior correspondent Nancy Beckley, president and CEO for Nancy Beckley and Associates, will return and report on all the latest hot topics and the Monitor Mondays Listener Survey.

  • News Update: RACmonitor national correspondent Timothy Powell will be reporting on the move by UnitedHealthCare to adjust or deny emergency department (ED) claims submitted with levels four and five evaluation and management (E&M) codes. RACmonitor broke that story with Dr. Hirsch in December of last year.

  • Auditing Report: Kristi Pollard, senior coding consultant at Haugen Consulting Group, will report on a top audit finding uncovered by her firm: discrepancies in secondary diagnosis assignment on outpatient claims.

  • Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron will report on another example of a potentially troublesome issue that could pose a risk to your facility.

Register now for this trending hot topics broadcast coming up at 10 a.m. EST on Monday, March 12.