Health Information Management Articles by Topic: Recovery Audit Contractors
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CDI Strategies, Issue 2, January 22, 2015
The battle over timely reviews for Medicare claims denials continues despite a federal...
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HIM-HIPAA Insider, Issue 2, January 12, 2015
The District of Columbia federal district court dismissed a lawsuit December 18, 2014, filed by the...
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HIM-HIPAA Insider, Issue 49, December 22, 2014
The American Hospital Association’s December 12 quarterly RACTrac survey revealed that nearly...
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CDI Strategies, Issue 24, November 20, 2014
The Office of the Inspector General (OIG) cited Yale-New Haven Hospital for errors which included...
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CDI Strategies, Issue 21, October 9, 2014
If the hospital documentation, including history and physical and progress notes, doesn't support...
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CDI Strategies, Issue 19, September 11, 2014
In exchange for dropping appeals, CMS says it will provide partial payment of previously denied...
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CDI Strategies, Issue 17, August 14, 2014
Due to the continued delay in awarding new Recovery Auditor (RA) contracts, CMS made modifications...
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CDI Strategies, Issue 15, July 17, 2014
Statistical sampling or alternative dispute resolution: These possible two solutions to the...
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CDI Strategies, Issue 14, July 3, 2014
If you haven’t seen the OIG report “Medicare Compliance Review of University of...
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CDI Strategies, Issue 13, June 19, 2014
Of all the Recovery Auditor denials, hospitals reported appealing about 50% with more than a 50...
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CDI Strategies, Issue 12, June 5, 2014
At the close of fiscal year 2013, nearly 5,000 claims denials remained pending review at the...
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CDI Strategies, Issue 6, March 13, 2014
The latest RACTrac survey from the American Hospital Association shows facilities 49% of denials...
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HIM-HIPAA Insider, Issue 6, February 10, 2014
CMS recently announced that it will extend the probe and educate period for review of admissions...
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HIM-HIPAA Insider, Issue 4, January 27, 2014
In a recent letter, the American Hospital Association (AHA) urged CMS to work with the Office of...
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CDI Strategies, Issue 2, January 16, 2014
Contractors could use a little guidance from CMS to do a better job at reviewing medical...
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CDI Strategies, Issue 2, January 16, 2014
Of the nearly 450 respondents to a recent ACDIS website poll, 50% say they conduct pre-payment...
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CDI Strategies, Issue 23, November 7, 2013
CMS will not conduct post-payment patient status reviews for admission dated October 1, 2013...
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HIM-HIPAA Insider, Issue 40, October 14, 2013
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CDI Strategies, Issue 19, September 12, 2013
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CMS issued new guidance last week aimed at clarifying the so-called...
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CDI Strategies, Issue 19, September 12, 2013
Although Recovery Auditors have identified more than a billion dollars in inappropriate payments...
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CDI Strategies, Issue 14, June 20, 2013
Three out of four Recovery Auditors (RAs) list medical necessity of cardiovascular procedures as...
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CDI Strategies, Issue 12, May 23, 2013
Recovery Auditor (RA) denials and good news never seem to go hand in hand. However, CMS announced...
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APCs Insider, Issue 19, May 10, 2013
Outpatient therapy services furnished between January 1 and December 31, 2013, are subject to a...
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HIM-HIPAA Insider, Issue 13, April 15, 2013
The Recovery Auditor (RA) program is alive and well judging by the number of news items popping up...
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CDI Strategies, Issue 8, April 11, 2013
Medical necessity for cardiovascular procedures is the top overpayment issue for three out of the...
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HIM-HIPAA Insider, Issue 10, March 25, 2013
The Medicare Audit Improvement Act, which aims to rectify problems identified in the Recovery...
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HIM-HIPAA Insider, Issue 9, March 18, 2013
In 2012, Recovery Auditors continued to expand their reach and gain speed. How has your facility...
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HIM-HIPAA Insider, Issue 9, March 18, 2013
Effective Wednesday March 13, hospitals denied payment because a Part A inpatient stay was deemed...
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CDI Strategies, Issue 6, March 14, 2013
Recovery auditor recoupments increased 14% since 2012, according to the 2013 Recovery Auditor...
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CDI Strategies, Issue 4, February 14, 2013
Recovery Auditors (previously called Recovery Audit Contractors [RAC]) saved Medicare nearly $500...
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CDI Strategies, Issue 27, December 20, 2012
The fight over medical necessity continued last week as the American Hospital Association and its...
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CDI Strategies, Issue 26, December 6, 2012
By Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, C-CDI, CCDS
In a recent CDI Talk conversation the...
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CDI Strategies, Issue 23, November 8, 2012
On October 16, Representative Sam Graves (R-MO) introduced legislation to reform Recovery...
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CDI Strategies, Issue 22, October 25, 2012
A bill, introduced October 16, aims to curtail the proliferation of healthcare audits and medical...
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CDI Strategies, Issue 21, October 11, 2012
Following the close of each fiscal year (FY) quarter, CMS releases statistics for the amount of...
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CDI Strategies, Issue 19, September 13, 2012
The terms “admitting” diagnosis and “principal” diagnosis are not...
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JustCoding News: Inpatient, Issue 37, September 12, 2012
Do you audit records before sending them to your Recovery Auditor? If not, your hospital may be one...
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CDI Strategies, Issue 18, August 30, 2012
RAC denials rose by 24% over the previous quarter, according to the August 22 RACTrac survey...
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JustCoding News: Inpatient, Issue 33, August 15, 2012
CMS officially announced the Recovery Auditor prepayment review demonstration in November 2011, but...
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HIM-HIPAA Insider, Issue 6, August 13, 2012
CMS officially announced the Recovery Auditor prepayment review demonstration this past November...
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CDI Strategies, Issue 16, August 2, 2012
On August 27, CMS launches its Recovery Audit Prepayment Review demonstration project. Over the...
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CDI Strategies, Issue 14, July 5, 2012
By Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDI, CCDS
Broaden the scope of your CDI...
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CDI Strategies, Issue 13, June 21, 2012
CMS recently posted two separate sets of data that provide nationwide statistics on its Recovery...
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HIM-HIPAA Insider, Issue 25, June 19, 2012
MACs have already begun prepayment reviews at hospitals nationwide, and Medicare Recovery Auditors...
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CDI Strategies, Issue 11, May 24, 2012
The Medicaid RAC program kicked off January 1. Although the program got off to a slow start...
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HIM-HIPAA Insider, Issue 21, May 22, 2012
In recent months there has been a number of Office of Inspector General (OIG) reports released that...
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CDI Strategies, Issue 10, May 10, 2012
“This claim was denied after review and it was determined that the documentation did not...
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HIM-HIPAA Insider, Issue 15, April 10, 2012
The Medicaid RAC program kicked off January 1, and experts say that although the program got off...
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HIM-HIPAA Insider, Issue 13, March 27, 2012
On March 9, the OIG published the report, “Review of CERT Errors Overturned Through the...
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HIM-HIPAA Insider, Issue 10, March 6, 2012
The Revenue Cycle Institute has released a new white paper, “2011 Recovery Auditor...
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CDI Strategies, Issue 5, March 1, 2012
More than 400 individuals responded to the “2011 Recovery Auditor Benchmarking Survey&rdquo...
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CDI Strategies, Issue 5, March 1, 2012
Review Medicaid Integrity Contractors (MICs) completed 81% of their CMS assignments resulting in...
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CDI Strategies, Issue 4, February 16, 2012
CMS’ Recovery Auditors (previously called Recovery Audit Contractors, now associated with the...
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JustCoding News: Inpatient, Issue 5, February 1, 2012
Just when you thought you had your RAC processes in place, more changes appear on the horizon. CMS...
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HIM-HIPAA Insider, Issue 1, January 3, 2012
On November 15, CMS announced that it will launch a number of demonstration programs that are set...
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JustCoding News: Inpatient, Issue 49, December 7, 2011
Coders should not underestimate the vital role they play in their organization’s efforts to...
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CDI Strategies, Issue 25, December 1, 2011
Starting in January 2012, facilities could see pre-payment reviews from auditors involved in a new...
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HIM-HIPAA Insider, Issue 47, November 22, 2011
As part of the ongoing effort to reduce improper payments in Medicare and Medicaid, CMS announced...
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HIM-HIPAA Insider, Issue 43, October 25, 2011
The American Hospital Association (AHA) will host four members-only conference calls—one for...
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HIM-HIPAA Insider, Issue 41, October 11, 2011
CMS released a revised RAC statement of work (SOW) September 12 that contains several revisions and...
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HIM-HIPAA Insider, Issue 40, October 4, 2011
It shouldn't come as a surprise that RACs use the Common Working File (CWF) to ensure that...
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CDI Strategies, Issue 20, September 29, 2011
On September 14, CMS released its Medicaid recovery audit contractor (RAC) final rule, which sets...
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HIM-HIPAA Insider, Issue 38, September 20, 2011
In February, the Centers for Medicare and Medicaid Services (CMS) delayed its expected April 1...
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HIM-HIPAA Insider, Issue 36, September 6, 2011
As of August 22, recovery auditors can request up to 35 records per 45 days from non-supplier and...
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CDI Strategies, Issue 18, September 2, 2011
To make up a gap in expected overpayment collections Recovery Audit Contractors may escalate audit...
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CDI Strategies, Issue 18, September 2, 2011
Out of 88 claims for MS-DRG 246 (percutaneous cardiovascular procedure with drug-eluting stent with...
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HIM-HIPAA Insider, Issue 34, August 23, 2011
RACs previously had been responsible for issuing demand letters to providers, but a July 29...
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HIM-HIPAA Insider, Issue 34, August 23, 2011
Denied claims got you down? An upper-level appeal may be the answer.
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CDI Strategies, Issue 17, August 18, 2011
In January facilities should expect to receive Recovery Audit Contractors (RAC) demand letters not...
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CDI Strategies, Issue 17, August 18, 2011
By Linda Renee Brown, RN, CCRN, CCDS, MA
One of the most confusing diagnoses to code and sequence...
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CDI Strategies, Issue 15, July 21, 2011
RACs can easily data-mine for noncompliance related to coding for ventilator support, says Glenn...
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CDI Strategies, Issue 15, July 21, 2011
Each month the Revenue Cycle Institute publishes a free sample tool or form for readers. This...
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HIM-HIPAA Insider, Issue 29, July 19, 2011
In the August issue of MRB, you’ll find articles on the following articles and more.
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CDI Strategies, Issue 14, July 7, 2011
Inpatient hospital claims submitted to Medicare contain “a significant amount” of...
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HIM-HIPAA Insider, Issue 27, July 5, 2011
CMS released two special edition MLN articles last week. One article, SE1121, highlights some of...
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HIM-HIPAA Insider, Issue 25, June 21, 2011
Not sure where to focus your RAC preparations these days? Look no further than the Program for...
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HIM-HIPAA Insider, Issue 25, June 21, 2011
In the July issue of MRB, you’ll find articles on the following articles and more!
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CDI Strategies, Issue 12, June 9, 2011
Q: With all the auditing going on I would like to find out how effects CDI programs in other...
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CDI Strategies, Issue 11, May 26, 2011
Recovery Audit Contractors (RAC) reported doubled its recovery amounts since last...
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HIM-HIPAA Insider, Issue 20, May 17, 2011
In the June issue of MRB, you’ll find articles on the following articles and more!
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CDI Strategies, Issue 10, May 12, 2011
What kind of return can your CDI program guarantee in terms of RAC preparedness? That’s the...
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CDI Strategies, Issue 10, May 12, 2011
Improper coding of MS-DRG 813 (coagulation disorders), reporting an extensive operating room...
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HIM-HIPAA Insider, Issue 19, May 10, 2011
CMS and the Medicare Learning Network (MLN) released the third Medicare Quarterly Provider...
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HIM-HIPAA Insider, Issue 19, May 10, 2011
Inpatient coders may lack familiarity with the ¬inpatient-only procedure list because CMS...
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HIM-HIPAA Insider, Issue 18, May 3, 2011
CMS released a short but useful Recovery Audit Contractor (RAC) update on its website last week...
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CDI Strategies, Issue 9, April 28, 2011
In response to President Barack Obama’s January 18 executive order aimed at reducing federal...
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HIM-HIPAA Insider, Issue 16, April 19, 2011
In the May issue of MRB, you’ll find articles on the following topics and more!
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HIM-HIPAA Insider, Issue 15, April 12, 2011
Providers familiar with automated claims reviews and complex claims reviews by the recovery RACs...
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HIM-HIPAA Insider, Issue 11, March 15, 2011
CMS recently increased the number of medical records that recovery audit contractors (RAC) can...
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HIM-HIPAA Insider, Issue 11, March 15, 2011
CMS updated the instructions related to processing underpayments indentified by RACs in Transmittal...
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HIM-HIPAA Insider, Issue 10, March 8, 2011
CMS has officially delayed the proposed April 1 deadline for states to implement their Medicaid RAC...
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HIM-HIPAA Insider, Issue 10, March 8, 2011
On February 23, the American Hospital Association sent a letter to CMS regarding the expansion of...
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CDI Strategies, Issue 5, March 3, 2011
If the data is true, the population of a couple of concentrated areas in California suffer from...
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CDI Strategies, Issue 5, March 3, 2011
Q: AHIMA’s 2008 practice brief, “Managing an Effective Query Process,” appears to...
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HIM-HIPAA Insider, Issue 9, March 1, 2011
Currently, providers respond to documentation requests from review contractors such RACs and...
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HIM-HIPAA Insider, Issue 8, February 22, 2011
On February 10, CMS announced a new listserv for the Medicare and Medicaid EHR incentive programs...
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CDI Strategies, Issue 4, February 17, 2011
The RACs have ramped up medical necessity reviews. Determining the medical necessity of an...
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CDI Strategies, Issue 4, February 17, 2011
A recent special edition MedLearn Matters article SE1028 outlines four risk areas targeted by the...
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HIM-HIPAA Insider, Issue 7, February 15, 2011
In two recently issued transmittals, CMS ordered all contractors – MACs, CERTs, RACs...
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HIM-HIPAA Insider, Issue 7, February 15, 2011
A patient’s medical record could include a laundry list of diagnoses, but not all of these...
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HIM-HIPAA Insider, Issue 7, February 15, 2011
In the March issue of MRB, you’ll find articles on the following topics and more!
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HIM-HIPAA Insider, Issue 5, February 1, 2011
On January 13, CMS released a new recovery audit contractor (RAC) FAQ regarding the requirement for...
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HIM-HIPAA Insider, Issue 3, January 18, 2011
CMS published a notice in the Federal Register December 27 asking for comments on the RAC program...
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HIM-HIPAA Insider, Issue 3, January 18, 2011
Now that medical record audits are the rule rather than the exception, inpatient rehabilitation...
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HIM-HIPAA Insider, Issue 2, January 11, 2011
With an ever-growing list of RAC-targeted MS-DRGs and a host of coding compliance traps that...
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CDI Strategies, Issue 1, January 6, 2011
Q: How should providers prepare for Medicaid RACs?
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CDI Strategies, Issue 26, December 23, 2010
The RAC program was fully under way in 2010, and providers continue to struggle with it as the year...
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HIM-HIPAA Insider, Issue 50, December 21, 2010
On December 10 CMS released Transmittal 361, Change Request 6988 that MACs, CERT, RACs, and ZPICs...
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HIM-HIPAA Insider, Issue 50, December 21, 2010
Signs are pointing to the fact that Medicaid RACs might not be the stuff of unicorns or Santa...
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HIM-HIPAA Insider, Issue 49, December 14, 2010
The language physicians use to create a patient’s clinical picture doesn’t always...
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CDI Strategies, Issue 24, November 24, 2010
CMS has modified the additional documentation request (ADR) limits (i.e., medical record request...
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HIM-HIPAA Insider, Issue 46, November 23, 2010
CMS has modified the additional documentation request (ADR) limits (i.e., medical record request...
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HIM-HIPAA Insider, Issue 46, November 23, 2010
Now that RAC medical necessity audits are well under way, the focus has shifted from anticipatory...
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HIM-HIPAA Insider, Issue 45, November 16, 2010
CMS released the long-anticipated proposed rule for Medicaid RACs November 5, setting the stage for...
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HIM-HIPAA Insider, Issue 45, November 16, 2010
Hospitals have waited with bated breath for RAC medical necessity audits to begin. Now that the...
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HIM-HIPAA Insider, Issue 43, November 2, 2010
On October 25, AHA News Now published information on a new CMS policy that prohibits Medicaid...
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Briefings on Coding Compliance Strategies, Issue 11, November 1, 2010
Learn about medical necessity audits, linking signs and symptoms with definitive conditions...
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HIM-HIPAA Insider, Issue 42, October 26, 2010
As hospitals move toward ICD-10, an overreliance on encoders could become more of a problem as...
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HIM-HIPAA Insider, Issue 39, October 5, 2010
In an effort to propagate useful information on RAC high-dollar improper payment vulnerabilities...
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HIM-HIPAA Insider, Issue 39, October 5, 2010
As providers navigate their way through complex reviews and the newly approved medical necessity...
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Briefings on Coding Compliance Strategies, Issue 10, October 1, 2010
Learn about new and revised ICD-9-CM codes, identifying high-risk vulnerabilities in preparation...
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CDI Strategies, Issue 19, September 16, 2010
Recent approval of a RAC issue for inpatient hospital claims review has initiated uncertainty...
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HIM-HIPAA Insider, Issue 35, September 7, 2010
According to a July HCPro survey of approximately 500 healthcare providers, 56% have already...
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CDI Strategies, Issue 18, September 2, 2010
Confusing coding guidelines and insufficient documentation have made neoplasms a target area as...
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CDI Strategies, Issue 18, September 2, 2010
CMS requires that orders for healthcare services be authenticated using either a handwritten or...
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HIM-HIPAA Insider, Issue 34, August 31, 2010
According to a July HCPro survey of approximately 500 healthcare providers, 56% have already...
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HIM-HIPAA Insider, Issue 13, August 24, 2010
In the September issue of MRB, you’ll find articles on the following topics and more!
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CDI Strategies, Issue 17, August 19, 2010
The Centers for Medicare & Medicaid Services (CMS) recently approved the first “medical...
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HIM-HIPAA Insider, Issue 32, August 17, 2010
The long wait for medical necessity RAC reviews will soon be over. CMS recently approved the first...
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CDI Strategies, Issue 16, August 5, 2010
It’s not enough to know whether heart failure is systolic or diastolic. Congestive heart...
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Briefings on Coding Compliance Strategies, Issue 8, August 1, 2010
It shouldn’t come as a surprise that HealthDataInsights—the RAC for Region D—is...
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Briefings on Coding Compliance Strategies, Issue 8, August 1, 2010
V codes play an important role in painting an accurate picture of an admission and facilitating...
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Briefings on Coding Compliance Strategies, Issue 8, August 1, 2010
Learn about avoidable V code traps, why you shouldn't bypass coding rules for more money, why...
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HIM-HIPAA Insider, Issue 29, July 27, 2010
Providers can make a great impact in terms of reducing RAC denials at their facilities with...
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HIM-HIPAA Insider, Issue 28, July 20, 2010
Q: What should providers know about CMS’ new RAC MLN Matters article?
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HIM-HIPAA Insider, Issue 26, July 6, 2010
Medically unnecessary services and incorrectly coded items had the highest amounts of RAC...
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Briefings on Coding Compliance Strategies, Issue 7, July 1, 2010
Inpatient admissions requiring mechanical ventilation tend to be high-dollar cases, which is...
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Briefings on Coding Compliance Strategies, Issue 7, July 1, 2010
Learn whether coders should delay sending a claim because of a missing discharge summary.
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HIM-HIPAA Insider, Issue 24, June 22, 2010
In the July issue of MRB, you’ll find the following articles and more!
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Briefings on Coding Compliance Strategies, Issue 6, June 1, 2010
You may think the discharge disposition codes you assign are correct, but discharge plans...
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Briefings on Coding Compliance Strategies, Issue 6, June 1, 2010
Learn about the three-day payment rule, FY 2011 IPPS Proposed Rule, discharge disposition codes...
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HIM-HIPAA Insider, Issue 21, June 1, 2010
On the May 12 RAC 101 call for physicians, a caller asked CMS specific information about when...
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HIM-HIPAA Insider, Issue 19, May 18, 2010
CMS representatives addressed two developing recovery audit contractor (RAC) areas during the May 5...
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HIM-HIPAA Insider, Issue 19, May 18, 2010
MS-DRG 432 (cirrhosis and alcoholic hepatitis with MCC) is one of many MS-DRGs slated for RAC...
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CDI Strategies, Issue 10, May 13, 2010
CMS has been holding a number of open forum calls regarding its Recovery Audit Contractor (RAC...
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HIM-HIPAA Insider, Issue 17, May 4, 2010
Did you know that the HCPro Revenue Cycle Institute is a great source for free tools for those in...
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HIM-HIPAA Insider, Issue 16, April 27, 2010
Overcoding and coding based on insufficient documentation may be one reason why RACs are auditing...
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HIM-HIPAA Insider, Issue 15, April 20, 2010
On April 13, CMS released the following new RAC FAQ: Can the RAC do a medical necessity review on a...
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HIM-HIPAA Insider, Issue 14, April 13, 2010
On April 6 CMS announced a series of upcoming RAC calls for different provider types.
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HIM-HIPAA Insider, Issue 14, April 13, 2010
RACs already are validating countless MS-DRGs in hospitals nationwide, and the number of eligible...
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HIM-HIPAA Insider, Issue 13, April 6, 2010
In the current regulatory environment many contractors review claims and medical documentation...
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HIM Briefings, Issue 4, April 1, 2010
Recovery audit contractor (RAC) activity is picking up, but many healthcare providers are still...
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HIM Briefings, Issue 4, April 1, 2010
This month's issue includes an article on HIMs role in surviving recovery audit contractor (RAC...
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HIM Briefings, Issue 4, April 1, 2010
As recovery audit contractors (RAC) begin to roll out complex reviews and request medical record...
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HIM-HIPAA Insider, Issue 12, March 30, 2010
Now that the Senate and House have put the finishing touches on the newly signed...
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HIM-HIPAA Insider, Issue 10, March 16, 2010
A March 10 White House memorandum on finding and recapturing improper payments has mandated...
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HIM-HIPAA Insider, Issue 10, March 16, 2010
In the April issue of MRB, you’ll find the following articles, and more!
EHR beat...
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CDI Strategies, Issue 5, March 4, 2010
Those who lived through the RAC demonstration project learned valuable lessons along the way...
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Briefings on Coding Compliance Strategies, Issue 3, March 1, 2010
Coders don't need a RAC audit to tell them that reporting inpatient wound care is particularly...
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HIM-HIPAA Insider, Issue 5, February 9, 2010
HIM directors can evaluate their hospital’s potential risk for overcoding and unnecessary...
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HIM-HIPAA Insider, Issue 5, February 9, 2010
As RACs begin to roll out complex reviews and request medical record documentation, compliant...
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HIM-HIPAA Insider, Issue 5, February 2, 2010
Nearly 20% of healthcare providers have already received Recovery Audit Contractor (RAC...
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HIM-HIPAA Insider, Issue 3, January 19, 2010
In recent weeks, HealthDataInsights (HDI) has added dozens of new issues to its CMS-approved list...
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HIM-HIPAA Insider, Issue 2, January 12, 2010
The American Hospital Association (AHA) offered comments and suggestions on the Senate and House...
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HIM Briefings, Issue 1, January 1, 2010
HCPro’s “RAC Preparedness Benchmarking Report” shows that HIM directors play a...
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HIM Briefings, Issue 1, January 1, 2010
This month’s 16-page expanded issue includes our four-page quarterly insert that focuses on...
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HIM-HIPAA Insider, Issue 52, December 29, 2009
DCS Healthcare, Connolly Healthcare, and HealthDataInsights (HDI), the RACs for regions A, C, and...
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HIM-HIPAA Insider, Issue 50, December 15, 2009
What will Medicaid Integrity Contractor auditors be looking for? Here are some possible issues...
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HIM-HIPAA Insider, Issue 50, December 15, 2009
In 2009, HCPro’s Revenue Cycle Institute conducted an in-depth study on recovery audit...
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HIM-HIPAA Insider, Issue 49, December 8, 2009
Connolly Healthcare has announced the first issues approved for complex RAC review, so providers in...
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HIM-HIPAA Insider, Issue 48, December 1, 2009
Budgets are tight, but many healthcare providers appear to be aware that setting aside resources to...
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HIM-HIPAA Insider, Issue 47, November 24, 2009
CMS has contracted with the TMF Health Quality Institute to again release Program for Evaluating...
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HIM-HIPAA Insider, Issue 46, November 17, 2009
Healthcare providers in several states received their first RAC denials. Connolly Healthcare, the...
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HIM-HIPAA Insider, Issue 40, October 6, 2009
Inpatient hospitals, inpatient rehabilitation facilities, skilled nursing facilities, and hospice...
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HIM-HIPAA Insider, Issue 38, September 22, 2009
DCS Healthcare has released its first CMS-approved issues for audits in Region A.
The three...
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HIM Briefings, Issue 9, September 1, 2009
The final phase of the national Recovery Audit Contractor (RAC) rollout began last month, and...
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HIM Briefings, Issue 9, September 1, 2009
This month’s issue covers a wide variety of topics of interest to HIM directors. Our cover...
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Briefings on Coding Compliance Strategies, Issue 9, September 1, 2009
In this issue, we dissect the final 2010 IPPS rule, plus discuss the three new NCDs for never...
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Briefings on Coding Compliance Strategies, Issue 9, September 1, 2009
Our experts help interpret CMS’ national coverage determinations, which include...
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HIM-HIPAA Insider, Issue 35, September 1, 2009
For many providers, self-auditing has become an important RAC preparation tool. Certainly, internal...
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HIM-HIPAA Insider, Issue 35, September 1, 2009
Region B, get ready. RACs may begin auditing at any time in several Region B states. CGI Federal...
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HIM-HIPAA Insider, Issue 34, August 25, 2009
Connolly Healthcare, the RAC for region C, has now posted issues for review in Florida, including...
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HIM-HIPAA Insider, Issue 33, August 18, 2009
HealthDataInsights, Inc. launched its new RAC Web site, and posted the first set of issues eligible...
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HIM-HIPAA Insider, Issue 32, August 11, 2009
Heads up, healthcare providers: Connolly Healthcare, the RAC for Region C, has posted the first set...
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HIM-HIPAA Insider, Issue 27, July 7, 2009
CMS released further information June 24 on its RAC Web site letting healthcare providers know when...
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Briefings on Coding Compliance Strategies, Issue 7, July 1, 2009
The job of the recovery audit contractors (RAC) is twofold: Identify overpayments to recoup excess...
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Briefings on Coding Compliance Strategies, Issue 7, July 1, 2009
In August, the recovery audit contractor (RAC) program will extend to all states nationwide. In...
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Briefings on Coding Compliance Strategies, Issue 7, July 1, 2009
The transition to ICD-10 and preparing for recovery audit contractors are two big issues for...
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HIM Briefings, Issue 7, July 1, 2009
How many record requests can HIM directors expect to receive now that the permanent Recovery Audit...
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HIM Briefings, Issue 7, July 1, 2009
This month’s expanded issue includes our 4-page quarterly insert about electronic health...
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HIM-HIPAA Insider, Issue 25, June 23, 2009
How many record requests can HIM directors expect to receive now that the permanent Recovery Audit...
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HIM-HIPAA Insider, Issue 23, June 9, 2009
CMS anticipates Recovery Audit Contractor (RAC) automated reviews will begin in late June and July...
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HIM-HIPAA Insider, Issue 22, June 2, 2009
CMS released four new and updated RAC FAQ on May 19. The FAQ range from the broad ("Why is CMS...
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Briefings on Coding Compliance Strategies, Issue 6, June 1, 2009
During its most recent Open Door Forum, held May 6, CMS discussed several inpatient-related topics...
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HIM-HIPAA Insider, Issue 21, May 26, 2009
CMS released a RAC FAQ April 29 with important news that may have previously flown under the radar...
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HIM-HIPAA Insider, Issue 19, May 12, 2009
Q: I’ve heard that the American Hospital Association (AHA) will be tracking the effects of...
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HIM-HIPAA Insider, Issue 19, May 12, 2009
During the three-year RAC demonstration project, payment for several inpatient debridement...
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Briefings on Coding Compliance Strategies, Issue 5, May 1, 2009
Two ICD-9 codes denote debridement in relation to wound care: 86.22, excisional debridement of...
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Briefings on Coding Compliance Strategies, Issue 5, May 1, 2009
Across the country, hospitals are focusing more time and energy on improving quality of care, not...
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APC Answer Letter, Issue 5, May 1, 2009
Inside:
Blood procedures: Code correctly when the only service is specimen collection via...
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HIM-HIPAA Insider, Issue 17, April 28, 2009
On April 13, CMS announced a pilot project to reduce rates of hospital readmissions. The Care...
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HIM-HIPAA Insider, Issue 15, April 14, 2009
A comprehensive database is the critical to managing recovery audit contractor (RAC) requests. The...
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HIM-HIPAA Insider, Issue 14, April 7, 2009
CMS will be holding two Special Open Door Forums on Recovery Audit Contractors (RAC) for Part A and...
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Briefings on Coding Compliance Strategies, Issue 4, April 1, 2009
During its most recent Open Door Forum (ODF) on February 25, CMS discussed several...
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Briefings on Coding Compliance Strategies, Issue 4, April 1, 2009
As part of a recent focus on patient safety, CMS has ramped up its efforts to curb...
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Briefings on APCs, Issue 4, April 1, 2009
Inside:
Watch for changing physician supervision requirements
Few changes to date in HCPCS...
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APCs Insider, Issue 13, March 27, 2009
Recovery audit contractors (RAC) cannot randomly select or target a claim "solely because it...
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HIM-HIPAA Insider, Issue 12, March 24, 2009
On March 19, CMS posted a schedule that includes various provider outreach sessions for regions A...
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APCs Insider, Issue 9, February 27, 2009
With RAC officially underway, hospitals and providers should begin fine-tuning their RAC...
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HIM-HIPAA Insider, Issue 7, February 17, 2009
The Medicare Recovery Audit Contractor (RAC) program is moving full speed ahead now that CMS has...
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APCs Insider, Issue 7, February 13, 2009
CMS announced February 6 the permanent RAC program is once again underway as the RAC bid protests...
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HIM-HIPAA Insider, Issue 2, January 13, 2009
CMS revised its July 2008 RAC appeal update to include appeals statistics through August 31, 2008.
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APCs Insider, Issue 1, January 2, 2009
The RAC demonstration project revealed several target areas. HIM directors should focus on these...
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HIM Briefings, Issue 1, January 1, 2009
These days, the words “recovery audit contractor” (RAC) are on every HIM...
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HIM-HIPAA Insider, Issue 50, December 23, 2008
Kathy M. Johnson, RHIA, director of coding services at Care Communications in Chicago, says the RAC...
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Briefings on Coding Compliance Strategies, Issue 12, December 1, 2008
Officials answer questions during special ODF By now, one point remains clear: CMS has halted the...
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Briefings on Coding Compliance Strategies, Issue 12, December 1, 2008
CMS discusses RAC expansion, ICD-10, and never events CMS hosted a Hospital & Hospital Quality...
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HIM-HIPAA Insider, Issue 45, November 18, 2008
Regardless of the fact that CMS announced November 3 that it would delay all recovery audit...
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CDI Strategies, Issue 23, November 13, 2008
CMS has delayed the Medicare Recovery Audit Contractor (RAC) permanent program and put a moratorium...
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HIM-HIPAA Insider, Issue 44, November 11, 2008
CMS announced on November 3 that it has delayed the Medicare Recovery Audit Contractor (RAC...
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Briefings on Coding Compliance Strategies, Issue 11, November 1, 2008
Forty percent of Medicare admission denials relate to improper one-day stays. If this statistic...
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CDI Strategies, Issue 21, October 16, 2008
CMS announced the new Medicare Recovery Audit Contractors (RACs) for its permanent nationwide...
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APCs Insider, Issue 18, May 2, 2008
Hospitals nationwide are taking notice of the Recovery Audit Contractor (RAC) program and the 2007...
