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This information is provided courtesy of Payment Automation Network, Inc. www.PaymentAutomation.net Providing Cash Flow Solutions for Medical Providers Nationwide
Recovery Audit Contractors (RACs)  Medicare. Medicaid and Commercial Insurance Investigations  What you Need to Know
Agenda  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recovery Audit Contract-”RAC” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Regions and timelines *RACs are required to perform  outreach programs for all providers in their region From CMS D C B A March 1, 2009  March 1, 2009    March 1, 2009  March 1, 2009  March 1, 2009 March 1, 2009 August 1, 2009  August 1, 2009   August 1, 2009 Provider Outreach Claims Available for Analysis Earliest Correspondence
How the Medicare RAC Audits affect Medical Providers If the providers bill  Fee-for-Service  Medicare, Medicaid or Commercial Insurance programs, their claims will be subject to review by the investigators and auditors
Who has the Authority ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
What about the other entities ,[object Object],[object Object],[object Object],[object Object]
What does the RAC do? ,[object Object],[object Object],[object Object],[object Object]
Fiscal Year 09 Medical Record Limits  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Importance of Documentation Compliance ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When the RAC Letter arrives ,[object Object],[object Object],[object Object],[object Object],[object Object]
Next Steps from the RAC ,[object Object],[object Object]
The Collection Process  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Disagreement –No Appeal ,[object Object],[object Object],[object Object]
Appeals ,[object Object],[object Object],[object Object],[object Object]
What to Expect Next ,[object Object]
Where do you turn? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
How Can the Payment Automation Network Baseline Audit Service Help You? ,[object Object],[object Object],[object Object]
How We Help You Get Prepared ,[object Object],[object Object],[object Object]
Beyond the BaseLine Audit Review ,[object Object],[object Object],[object Object],[object Object],Payment Automation Network, Inc. is Your Solution
RAC Preparation Support Medicare Documentation & Coding Benchmark Audit ,[object Object],[object Object],Fax to HIPAA secure site  (iDocumentNow)  for certified coders to review Documentation and coding Compliance audit performed by certified coders Web-based Training Audit Report ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Sample report to follow
Guess who’s coming to the Audit Table ,[object Object],[object Object],[object Object],[object Object],[object Object]
How We Can Help ,[object Object]
So why should I use your service for a baseline audit prior to being audited by the RAC? ,[object Object]
So why should I use your service for a baseline audit prior to being audited by the RAC? ,[object Object]
So why should I use your service for a baseline audit prior to being audited by the RAC? ,[object Object]
How do I schedule a Medicare RAC Baseline Audit with your company?   ,[object Object]
Review ,[object Object],[object Object],[object Object],[object Object]
Thank You ,[object Object],[object Object],[object Object],[object Object],[object Object]

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Medicare RAC Auditors are coming. Is your practice ready?

  • 1. This information is provided courtesy of Payment Automation Network, Inc. www.PaymentAutomation.net Providing Cash Flow Solutions for Medical Providers Nationwide
  • 2. Recovery Audit Contractors (RACs) Medicare. Medicaid and Commercial Insurance Investigations What you Need to Know
  • 3.
  • 4.
  • 5. Regions and timelines *RACs are required to perform outreach programs for all providers in their region From CMS D C B A March 1, 2009 March 1, 2009 March 1, 2009 March 1, 2009 March 1, 2009 March 1, 2009 August 1, 2009 August 1, 2009 August 1, 2009 Provider Outreach Claims Available for Analysis Earliest Correspondence
  • 6. How the Medicare RAC Audits affect Medical Providers If the providers bill Fee-for-Service Medicare, Medicaid or Commercial Insurance programs, their claims will be subject to review by the investigators and auditors
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