Improper payments may be over or under payments received by Medicare

Under payments occur when the medical record i ndicates that something more complicated was perforrmed.  The RAC Audit can reveal both problems.  The RACs have been retained to uncover inappropriate paymentws made on claims of healthcare services provided to medicare beneficiaries.  

 

96% of the inappropriate payments are overpayments resulting in over 1 Billion collected.  Overpayments occur when providders submit claims that do not meet CMS coding.  Just three RACs are retained to find inappropriate payments, the othwr three look for situations where MediCare should not have paid at all because other insurance was in place covering the service.  

It is imperative that physicians and practice groups contact their medical malpractice Carrier for resources to help them prior to being named in an audit:  Educate staff about coding:  Develop a RAC Compliance plan, Designate a RAC response team and leader (this is where our Mediguard Plus comes through for our physicians):  track and report and analyze audit patterns, corrective plans of action,  Monitor the trends and enforce in region.  You can check on the RAC website to see which issues they are auditing most frequently,  Involve legal counsel early.

Call The Doctors Insurance Agency for assistance with compliance process plans and insurance
.

Comments are closed for this post, but if you have spotted an error or have additional info that you think should be in this post, feel free to contact us.
  1. Re: Developing Walk In and Urgent Care Centers

    http://www.jordans11shoes.us.com/ jordan retro http://www.adidasnmdrunnerr1.us.com/ ultra boost mens...

    -- yanxia39

  2. Re: Physicians Who Return From Retirement Within Two Years Are Allowed to Reinstate Their Old Policy

    http://www.kyrie-4.us.com/ kyrie shoes http://www.jordans11shoes.us.com/ jordan 13 http://www.adidasyeezy...

    -- changhon62

  3. Re: Do Medispas need Liability Insurance?

    http://www.adidas-ultraboost.us.com/ yeezy boost http://www.pandorajewelryscharms.us.com/ pandora http...

    -- jingting17

  4. Re: Vicarious Liability Medical Malpractice, The Challenge with Medical Malpractice Insurance

    http://www.adidasyeezy-350.us.com/ adidas boost http://www.pandorajewelryrings.us.com/ pandora bracelet...

    -- xiuying23

  5. Re: Working to get you a better Podiatry premium.

    http://www.adidasyeezy-350.us.com/ adidas originals nmd http://www.yeezyboost350shoes.us.com/ yeezy ...

    -- jingting17

  6. Re: Tort Reform, Claims Frequency

    http://www.hermesbirkin-handbags.us.com/ hermes handbags http://www.adidasyeezy-350.us.com/ ultra boost...

    -- yaling45

  7. Re: The Podiatrists Market Research Report states that demand for podiatrists will likely benefit from healthcare reform.

    http://www.hermesbirkin-handbags.us.com/ hermes handbags http://www.adidasnmdrunnerr1.us.com/ nmd http...

    -- yaling45

  8. Re: Clinical Trial. Drug Discovery

    http://www.fitflopsshoes.us.com/ fitflops clearance http://www.kd10-shoes.us.com/ kd 9 elite http://www...

    -- yanxia39

  9. Re: What to do When you're Podiatry Malpractice Insurance Policy is Canceled?

    http://www.adidas-ultraboost.us.com/ yeezy boost 350 http://www.adidasyeezy-350.us.com/ adidas ultra...

    -- xiuying23

  10. Re: Include the Center’s Liability in Your Group Medical Malpractice Insurance Policy or …Insure that Lab/Center Separately?

    http://www.pandorajewelryscharms.us.com/ pandora http://www.airmax90shoes.us.com/ nike air vapormax http...

    -- changhon62