In CMS
Oct 13th, 2008
The Centers for Medicare & Medicaid Services (CMS) awarded contracts to four permanent Recovery Audit Contractors (RACs) as announced in an Oct. 6 Fact Sheet. They are: Diversified Collection Services, Inc. of Livermore, Calif.: Region A, initially working in Maine, New Hampshire, Vermont, Massachusetts, Rhode Island, and New York. CGI Technologies and Solutions, Inc. of ...
Sep 29th, 2008
With health care providers operating under increased regulatory scrutiny, you can never be too prepared for recovery audit contractors (RACs). Before you land yourself in an auditing pickle that costs you more than you can afford to loose, HCPro Revenue Cycle Institute’s The RAC Report Tips to Prepare for RACs has a starting place to ...
Jun 1st, 2008
Brad Ericson, CPC, CPC-ORTHO A new federal auditing program is coming to city near you. The Recovery Audit Contractor (RAC) program, created in 2004 through the Medicare Modernization Act (MMA) to safeguard the Medicare Trust Fund, identifies Medicare and Medicaid overpayments and requests repayments from facilities, physician practices, and DME providers. A demonstration project begun ...
Mar 1st, 2007
Barbara J. Cobuzzi, MBA, CPC, CPC-H, CPC-P, CHCC, CRN When used appropriately, modifier 59 tells a payer that, due to special circumstances, two codes that are normally “bundled” (by either National Correct Coding Initiative, NCCI, edits or CPT guidelines) should be paid separately. But because modifier 59 is such a powerful tool — and because providers may apply it to increase payments inappropria...