How has your facility integrated the Recovery Audit Contractor Program (RAC)?

According to CMS’s most recent update of March 2011, overpayments collected since the demonstration amount to $313.2 million while underpayments are limited to $52.6 million. With a 6:1 ratio in favor of overpayments collected, how long can your facility hold off a RAC collection?

New issues are being added every week for validation and/or medical necessity review. Find out the Top Issue per Recovery Auditor announced by CMS in their Medicare Fee-for-Service Recovery Audit Program as of March 2011 .

Stop RAC Overpayments at your facility

Amphion Medical Solutions provides expert services in data mining to identify those MS-DRGs on your RAC’s focus list that present the greatest financial risk to you. Amphion’s CCQM services include continuous pre-bill review of the targeted MS-DRGs to ensure your coding is accurate before you drop the bill.

Our CCQM services allows you to focus your internal resources on implementing the necessary process changes to retain your claims dollars while taking advantage of Amphion’s objective expertise in identifying your exposure for coding compliance in the RAC focus areas.

Amphion also provides expert MS-DRG denial appeal services. Our professionals have extensive experience in this area from prior employment with state QIO’s and the American Hospital Association. Contact us to work with your facility to construct appeal letters that will challenge inappropriate RAC denials.

Weekly RAC Updates

Update for February 9, 2012

Click here to sign up to receive Amphion’s weekly RAC Update via email.

Do not let compliance pressures stop your reimbursement.  Click here to contact us!

Continuous Coding Quality Monitoring for RAC

Let Amphion help you address DRG coding assignments before the RAC does. Find out more about our CCQM services for RAC.

Look for updates to your region’s RAC:

Region A: DCS
http://www.dcsrac.com/portal.html

Region B: CGI
http://racb.cgi.com

Region C: Connolly Consulting, Inc.
http://www.connollyhealthcare.com/RAC/Pages/cms_RAC_Program.aspx

Region D: HealthDataInsights, Inc
https://racinfo.healthdatainsights.com/Public/NewIssues.aspx

 

2012 RAC Updates Archive

February 2