Download or read book Status on the Use of Recovery Audit Contractors RACs in the Medicare Program written by United States. Department of Health and Human Services. Centers for Medicare & Medicaid Services and published by . This book was released on 2006 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Recovery Audit Contracting written by Kathleen M. King and published by DIANE Publishing. This book was released on 2010-08 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) conducted a three-year project to demonstrate the use of recovery audit contractors (RAC) in identifying Medicare improper payments and recouping overpayments. This report examined issues that arose during the demonstration project and CMS¿s efforts to address them in the national RAC program. It examines the extent to which CMS: (1) developed a process and took corrective actions to address vulnerabilities identified by the RACs that led to improper payments; (2) resolved coordination issues between the RACs and the Medicare claims admin. contractors; and (3) established methods to oversee RAC claim review accuracy and provider service during the national program. Charts and tables.
Download or read book Medicare Recovery Audit Contracting written by United States. Government Accountability Office and published by . This book was released on 2010 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Centers for Medicare & Medicaid Services (CMS) conducted a mandated 3-year project from March 2005 through March 2008 to demonstrate the use of recovery audit contractors (RAC) in identifying Medicare improper payments and recouping overpayments. CMS implemented a mandated national RAC program, which began in March 2009. GAO was asked to examine specific issues that arose during the demonstration project and CMS's efforts to address them in the national RAC program. This report examines the extent to which CMS (1) developed a process and took corrective actions to address vulnerabilities identified by the RACs that led to improper payments, (2) resolved coordination issues between the RACs and the Medicare claims administration contractors, and (3) established methods to oversee RAC claim review accuracy and provider service during the national program. GAO reviewed CMS documents and interviewed officials from CMS and contractors and provider groups affected by the demonstration project.
Download or read book Program Integrity written by United States. Congress. Senate. Committee on Finance and published by . This book was released on 2013 with total page 80 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Rac Toolkit for Physician Practices written by Elizabeth E. Lamkin and published by . This book was released on 2011-10-17 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: RACs are auditing practices. Learn how to prepare. The RAC Toolkit for Physician Practices is your practice's answer to turning plans into proactive action for RAC success. Authors Elizabeth Lamkin, MHA, and Amanda Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program. Physician practice settings are getting audited by RACs. Whether you're dealing with a RAC or another government auditor, you need a program that's running as effectively as it can be. You will use their tested, proven, and practical tools to build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical groups together for operational improvements that drop right to the bottom line. The RAC Toolkit for Physician Practices will help you get the job done right. The RAC Toolkit for Physician Practices will show you how to: * Take a systemic approach to RAC compliance * Incorporate effective structure and processes to existing systems for measurable results * Organize committees and facilitate information flow * Appeal effectively and within deadlines * Use proven tools and methods for an effective RAC program
Download or read book The Medicare Recovery Audit Contractor Program written by Duane C. Abbey and published by CRC Press. This book was released on 2017-11-15 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicare fraud is big business, but while only a few profit from intentional malfeasance, the Centers for Medicare and Medicaid Services is now taking a closer look at everyone. The Medicare Recovery Audit Contractor Program, already infamously known as the RAC, swings into full operation in 2010 and every healthcare provider that receives payment
Download or read book Medicaid Program Recovery Audit Contractors Us Centers for Medicare and Medicaid Services Regulation Cms 2018 Edition written by The Law The Law Library and published by Createspace Independent Publishing Platform. This book was released on 2018-06-16 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medicaid Program - Recovery Audit Contractors (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) The Law Library presents the complete text of the Medicaid Program - Recovery Audit Contractors (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition). Updated as of May 29, 2018 This final rule implements section 6411 of the Patient Protection and Affordable Care Act (the Affordable Care Act), and provides guidance to States related to Federal/State funding of State start-up, operation and maintenance costs of Medicaid Recovery Audit Contractors (Medicaid RACs) and the payment methodology for State payments to Medicaid RACs. This rule also directs States to assure that adequate appeal processes are in place for providers to dispute adverse determinations made by Medicaid RACs. Lastly, the rule directs States to coordinate with other contractors and entities auditing Medicaid providers and with State and Federal law enforcement agencies. This book contains: - The complete text of the Medicaid Program - Recovery Audit Contractors (US Centers for Medicare and Medicaid Services Regulation) (CMS) (2018 Edition) - A table of contents with the page number of each section
Download or read book Medicare Contractors Efforts to Fight Fraud written by United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Oversight and Investigations and published by . This book was released on 2013 with total page 124 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services Education and Related Agencies Appropriations for 2011 Part 2B 111 2 Hearings written by and published by . This book was released on 2010 with total page 1774 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Care Finance and the Mechanics of Insurance and Reimbursement written by Michael K. Harrington and published by Jones & Bartlett Learning. This book was released on 2019-10-01 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: Health Care Finance and the Mechanics of Insurance and Reimbursement stands apart from other texts on health care finance or health insurance, in that it combines financial principles unique to the health care setting with the methods and process for reimbursement (including coding, reimbursement strategies, compliance, financial reporting, case mix index, and external auditing). It explains the revenue cycle in detail, correlating it with regular management functions; and covers reimbursement from the initial point of care through claim submission and reconciliation. Thoroughly updated for its second edition, this text reflects changes to the Affordable Care Act, Managed Care Organizations, new coding initiatives, new components of the revenue cycle (from reimbursement to compliance), updates to regulations surrounding health care fraud and abuse, changes to the Recovery Audit Contractors (RAC) program, and more.
Download or read book AI Assisted Business Analytics written by Joseph Boffa and published by Springer Nature. This book was released on 2023-11-29 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: The primary path to success, is to use software designed to sample and analyze cashflow and then link that analysis, with forecasting and market research. The case study will start with a small business income statement indicating a cashflow problem. The analysis that follows will be a comprehensive statistical approach of fiscal management. The case study will provide an overview of the total process of controlling and analyzing cashflow. Business prosperity depends on: 1- Staying in touch with cashflow by means of regular statistical audits 2- Transition to statistical methods for forecasting future cashflow 3- Link cashflow with customer perception and satisfaction The book is intended for courses with prerequisites that the student has a knowledge of accounting and is comfortable in using Excel. It uses professional Excel with its Analytics Toolkit. Complete knowledge of the Toolkit is not a prerequisite since the book will adequately cover the relevant analytic tools. There is no need for separate statistical software such as SPSS or SAS. The book is intended for intermediate/advanced college level courses in business financial methods and control.
Download or read book Medicare Handbook 2020 Edition IL written by Stein, Chiplin and published by Wolters Kluwer. This book was released on 2019-12-16 with total page 834 pages. Available in PDF, EPUB and Kindle. Book excerpt: To provide effective service in helping people understand how they are going to be affected by health care reform and how to obtain coverage, pursue an appeal, or plan for long-term care or retirement, you need the most current information from a source you can trust - Medicare Handbook. This is the indispensable resource for clarifying Medicare's confusing rules and regulations. Prepared by an outstanding team of experts from the Center for Medicare Advocacy, it addresses issues you need to master to provide effective planning advice or advocacy services, including: Medicare eligibility rules and enrollment requirements; Medicare covered services, deductibles, and co-payments; coinsurance, premiums, penalties; coverage criteria for each of the programs; problem areas of concern for the advocate; grievance and appeals procedures. The 2020 Edition of Medicare Handbook offers expert guidance on: Medicare Enrollment and Eligibility Medicare Coverage in all Care-Settings Medicare Coverage for People with Chronic Conditions Medicare Home Health Coverage and Access to Care Prescription Drug Coverage Medicare Advantage Plans Medicare Appeals Health Care Reform And more! In addition, Medicare Handbook will help resolve the kinds of questions that arise on a regular basis, such as: How do I appeal a denial of services? What steps do I need to take in order to receive Medicare covered home health care? What are the elements of Medicare's appeal process for the denial of coverage of an item, service, or procedure? Does my state have to help me enroll in Medicare so that I can get assistance through a Medicare Savings Program? When should I sign up for a Medigap plan? If I am enrolled in Medicare, do I have to buy health insurance in the insurance marketplace created by the Affordable Care Act? Is it true that I have to show medical improvement in order to get Medicare for my nursing and therapy services? And more! The 2020 Medicare Handbook is the indispensable resource that provides: Extensive discussion and examples of how Medicare rules apply in the real world Case citations, checklists, worksheets, and other practice tools to help in obtaining coverage for clients, while minimizing research and drafting time Practice pointers and cautionary notes regarding coverage and eligibility questions when advocacy problems arise, and those areas in which coverage has often been reduced or denied And more! Previous Edition: Medicare Handbook, 2019 Edition ISBN 9781543800456
Download or read book Departments of Labor Health and Human Services Education and Related Agencies Appropriations for 2011 written by United States. Congress. House. Committee on Appropriations. Subcommittee on the Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2010 with total page 1782 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Departments of Labor Health and Human Services and Education and Related Agencies Appropriations for Fiscal Year 2017 written by United States. Congress. Senate. Committee on Appropriations. Subcommittee on Departments of Labor, Health and Human Services, Education, and Related Agencies and published by . This book was released on 2017 with total page 866 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Eliminating and Recovering Improper Payments written by United States. Congress. Senate. Committee on Homeland Security and Governmental Affairs. Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security and published by . This book was released on 2008 with total page 168 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Medicare Handbook written by Judith A. Stein and published by Wolters Kluwer. This book was released on 2012-11-27 with total page 988 pages. Available in PDF, EPUB and Kindle. Book excerpt: To provide effective service in helping clients understand how they are goingto be affected by health care reform and how to obtain coverage, pursue anappeal, or plan for long-term care or retirement, you need the latest Medicareguidelines from a source you can trust - the 2013 Edition ofMedicare Handbook .Prepared by experts from the Center for Medicare Advocacy, Inc.,Medicare Handbook covers the issues you need to provide effectiveplanning advice or advocacy services, including:Medicare eligibility and enrollmentMedicare-covered services, deductibles, and co-paymentsCo-insurance, premiums, and penaltiesFederal coordinated care issuesGrievance and appeals proceduresFace-to-face encounter requirements for home health and hospice careMedicare Handbook also provides you with coverage rules for:Obtaining Medicare-covered servicesPrescription drug benefit and the Low-Income Subsidy (LIS)The Medicare Advantage ProgramDurable Medical Equipment (DME)Preventive servicesAppealing coverage denialsand an understanding of:The Medicare Secondary Payer Program (MSP)The Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)Competitive Acquisition ProgramIncome-related premiums for Parts B and DThe 2013 Edition has been updated to include information andstrategies necessary to incorporate ACA provisions on behalf of people in needof health care.In addition, the 2013 Medicare Handbook will also help advocatescontest limited coverage under private Medicare Part C plans (MedicareAdvantage) and understand initiatives to reduce overpayments to MedicareAdvantage.Other Medicare developments discussed in the 2013 Medicare Handbookinclude:Implementation of important provisions of the Affordable Care ActBeneficiary rights, when moving from one care setting to anotherDevelopments in the Medicare Home Health and Hospice BenefitsAdditional information regarding preventive benefitsContinued changes in Medicare coverage for durable medical equipment
