Tag Archives: CMS Medicare RAC

CMS Cuts RAC Reviews 75%

Drastic Cut in Hospital ADR Limits The Centers for Medicare & Medicaid Services (CMS) is cutting the Recovery Audit Contractors’ (RACs) universe of hospital claims to review, and the number of records they may request from a hospital, by 75% … Continue reading

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“Finally Friday!” Strategies for Medicare Level 3 Appeals

FRIDAY October 17, 2014 Medicare Appeals at Level 3: Providers Left in the Lurch Veteran Appeals Attorneys Review Recent Experiences with ALJs How Can You Prepare & Respond? Watch the Replay and Get the Handouts Since CMS began re-educating the … Continue reading

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New CMS RAC Contract Awards Blocked by Federal Court

The U.S. Court of Federal Claims blocked the Centers for Medicare and Medicaid Services (CMS) from awarding new Recovery Audit Contractor (RAC) contracts pending a court appeal filed on August 22, 2014, by CGI Federal (CGI), one of the prospective … Continue reading

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News from the Week of February 28

The Pause Expands Last Month, CMS extended the pause (I refuse to call it a moratorium) on RAC reviews of Medicare claims under the  2 Midnight Rule to a full year, from Oct. 1, 2013 to Sept. 30, 2014. MACs, … Continue reading

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News from the Week of February 14

OMHA Forum Shockers Quoting staggering numbers of appeals that are stuck in the mail room, much less not yet assigned to a Judge, the Administration Law Judges gave an organized forum. Chief ALJ Nancy Griswold stated that OMHA is committed … Continue reading

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“Finally Friday!” Review: The Physician Advisor & UR Team Boot Camp

This session was recorded on Friday, July 26, 2013. Today’s show is an overview of some of the talks we heard at the PA Boot Camp, with a review of some of the key talks, including video snippets from them.

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“Finally Friday!” What’s the Diff?: Calculating Part A to Part B Billing

This session was recorded on Friday, July 19, 2013. Today we’re taught by Mike Snyder of Anchor Provider Solutions, how to calculate the difference between billing a claim as Part A versus billing it as Part B, which is important … Continue reading

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“Finally Friday!” Denise Wilson: The Art & Science of Writing Effective Appeals

This session was recorded on Friday, July 12, 2013. Today’s show is an overview by Denise Wilson of Appeal Masters on the Art & Science of Writing Effective Appeals — And Denise knows both sides of the coin, so to … Continue reading

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“Finally Friday!” Multiple Subjects: MACs, RACs, Part B Rebill, and FAX Issues

This session was recorded on Friday, July 5, 2013. Today’s show goes over multiple subjects, and we hear from Sharon Easterling of Recovery Analytics, and Richelle Beckman of the Forbes Law Group.  Here’s a list of what we discussed: Part B … Continue reading

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