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Big bad Medicare audits, or, being put on the RAC

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By this point, pretty much everyone in the industry is aware that Medicare is stepping up the Recovery Audit Contractor program, under which contractors visit with providers and do a deep, hard audit of their Medicare claims. Without a doubt, this is going to be a hot topic at the show this year. After all, not only are doctors vulnerable, small practices are as well--in a particularly bad way--as few can afford to mount a vigorous fight if they're accused of owing big bucks.

Not only is Medicare expanding the RAC program, it's likely to increase the number of providers from which it wants money. After all, in 96 percent of RAC decisions, the contractor decides that the provider owes the government money. Worse, only a tiny percentage of RAC decisions were overturned on appeal. Scary stuff.

If you're among the worried, one option is to attend "Provider Beware: Protecting Your Company from Government Audits and Investigations," (CON 713), a concurrent session given by two attorneys. It is designed to help healthcare leaders identify the issues that typically trigger a Medicare/Medicaid audit or investigation, familiarize themselves with the legal risks a provider faces and demonstrate how a health care organization can defend itself during an audit or investigation. Folks, I think this one is going to be popular, so come early.

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RAC was also a huge topic of concern at this week's AHIMA conference in Seattle (American Health Information Management Association). Focus at AHIMA was on how providers can better manage the deluge of requests for medical records, track the review and appeal process, and ultimately predict and manage the revenue impact. One vendor, HealthPort (www.healthport.com), provided an excellent panel session at the conference and has developed a web-based tracking solution. Providers at all levels will need technology to help manage RAC. Be on the look out at MGMA for companies who understand the back-end issues and are up-to-speed on RAC.

Medicare RAC =

"2009, Healthcare $1 Trillion Bubble"

You Must Pay to Bailout

You ARE the Bailout Plan, not Congress

In Your Entire Healthcare Industry Life, Most of Us Have Been Always Bending Backward Or Remaining Clueless In Dealing With Medicare And Insurance Companies When They Denied Your Claims, And Asked Your For Money Back Under The Ghost Name Of "Anti-Fraud", But This Time You Can't Afford To Pay Back To Bailout $1 Trillion U.S. Healthcare Bubble, Much Bigger Than Mortgage, Credit Card, And Stock Market Bubble. The Congress Will Not Offer Another $1 Trillion Bailout Plan For U.S. Healthcare Industry, The Industry Is Counting On You To Bailout. You Badly Need "Joe, The Plumber" To Bail You Out From 2009 $1 Trillion U.S. Healthcare Bubble Prison, aka, Your Financial Bankruptcy + Anti-Fraud Verdict."

I am appealed how that can be.I have medicare and if weren't so many frauds I can have better health care and maybe then doctors and provides can have better and faster payment from cms.

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