Muse Matters - Spring 2009 - (Page 38) RAC is Coming to US Hospitals: HOW to Survive GENERAL RAC FACTS RAC audit companies cannot subject claims submitted before October 1, 2007, to RAC review. Furthermore, there is a blackout time if your hospital has recently moved to Medicare Administrative Contractors (MAC). Hospitals should appeal any and all denials that are deemed incorrect after review by the hospital’s RAC Review Team. One question commonly asked is, “Should our hospital allocate reserve funds to cover the possibility of recoupment due to RAC?” Some experts suggest you make an estimate based upon 2% of your Medicare payments for each year and retain this total over and above normal reserves. Others suggest review of your current CBR (coding, billing and reimbursement) compliance activities. More detailed RAC facts, together with additional recommendations on how you can survive: • Complex audit requests from RAC require submission of medical records. Include all documentation that supports your coding and billing, and include a cover letter for each request. Form a RAC Review Team to review all documentation that you submit and do not miss the 45-day deadline. If you miss the deadline, the RAC audit company will start the recoupment process. Your RAC Review Team could also review all denials and make the decision about whether or not to move forward with an appeal whenever necessary. • No more than 10% of your average monthly Medicare claims (with a maximum of 200 records) can be requested within a 45-day period. Track records requested for complex review, as well as accounts selected for “auto” review (where a determination will be made by the RAC company without submission of the supporting records). RAC Phase In Schedule * D B A March 1, 2009 March 1, 2009 C August 1, 2009 or later *VT, NH, ME, MA, RI, CT (J14) Part A claims (including Part B of A) will not be available for RAC review until August 2009 due to the MAC transition. Part B claims in RI will not be available for RAC review until August 2009 due to the MAC transition. All other Part B claims are available for RAC review beginning March 1, 2009. 37 SPRING 2009 MUSE INTERNATIONAL Table of Contents Feed for the Digital Edition of Muse Matters - Spring 2009 Muse Matters - Spring 2009 Muse Matters - Spring 2009 - (Page 1) Muse Matters - Spring 2009 - (Page 2) Muse Matters - Spring 2009 - (Page 3) Muse Matters - Spring 2009 - (Page 4) Muse Matters - Spring 2009 - (Page 5) Muse Matters - Spring 2009 - (Page 6) Muse Matters - Spring 2009 - (Page 7) Muse Matters - Spring 2009 - (Page 8) Muse Matters - Spring 2009 - (Page 9) Muse Matters - Spring 2009 - (Page 10) Muse Matters - Spring 2009 - (Page 11) Muse Matters - Spring 2009 - (Page 12) Muse Matters - Spring 2009 - (Page 13) Muse Matters - Spring 2009 - (Page 14) Muse Matters - Spring 2009 - (Page 15) Muse Matters - Spring 2009 - (Page 16) Muse Matters - Spring 2009 - (Page 17) Muse Matters - Spring 2009 - (Page 18) Muse Matters - Spring 2009 - (Page 19) Muse Matters - Spring 2009 - (Page 20) Muse Matters - Spring 2009 - (Page 21) Muse Matters - Spring 2009 - (Page 22) Muse Matters - Spring 2009 - (Page 23) Muse Matters - Spring 2009 - (Page 24) Muse Matters - Spring 2009 - (Page 25) Muse Matters - Spring 2009 - (Page 26) Muse Matters - Spring 2009 - (Page 27) Muse Matters - Spring 2009 - (Page 28) Muse Matters - Spring 2009 - (Page 29) Muse Matters - Spring 2009 - (Page 30) Muse Matters - Spring 2009 - (Page 31) Muse Matters - Spring 2009 - (Page 32) Muse Matters - Spring 2009 - (Page 33) Muse Matters - Spring 2009 - (Page 34) Muse Matters - Spring 2009 - (Page 35) Muse Matters - Spring 2009 - (Page 36) Muse Matters - Spring 2009 - (Page 37) Muse Matters - Spring 2009 - (Page 38) Muse Matters - Spring 2009 - (Page 39) Muse Matters - Spring 2009 - (Page 40) Muse Matters - Spring 2009 - (Page 41) Muse Matters - Spring 2009 - (Page 42) Muse Matters - Spring 2009 - (Page 43) Muse Matters - Spring 2009 - (Page 44) Muse Matters - Spring 2009 - (Page 45) Muse Matters - Spring 2009 - (Page 46) Muse Matters - Spring 2009 - (Page 47) Muse Matters - Spring 2009 - (Page 48) http://www.nxtbookMEDIA.com
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