Good Morning all, I just read some information published by Eli's Rehab Report regarding recovery audit contractors (RAC). It seems that Medicare is setting up these RACs in three pilot locations (New York, Florida and California) to review therapy claims after payment has been made in order to determine overpayments. The problem I see with this is that Eli reports that the RACs will be paid by retaining a percentage of whatever overpayment they recover. Nothing like motivation. This is planed to start in May, so if you are practicing in one of these states, this is an official heads up! I would assume this will place an emphasis on a practitioners ability to document skilled service, medical necessity, progress and potential for progress. It is unclear if they will attempt to recoup monies for technical errors (i.e. not using ICD-9 codes that denote medical necessity or using CPT codes which conflict based on the CCI edits). I would presume that this will be fair game.
If you want more information visit the following link: http://www.cms.hhs.gov/medlearn/matters/mmarticles/2005/se0469.pdf Jimmie Arceneaux, LOTR Metro Preferred Home Care 3501 N. Causeway Blvd., Ste 200 Metairie, LA 70002 504-838-7080 Fax 504-833-9309 *** NOTICE--The attached communication contains privileged and confidential information. If you are not the intended recipient, DO NOT read, copy, or disseminate this communication. Non-intended recipients are hereby placed on notice that any unauthorized disclosure, duplication, distribution, or taking of any action in reliance on the contents of these materials is expressly prohibited. If you have received this communication in error, please delete this information in its entirety and contact the Amedisys Privacy Hotline at 1-866-518-6684. Also, please immediately notify the sender via e-mail that you have received this communication in error. *** -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] Help? [EMAIL PROTECTED]
