ALERT: RAC Auditing Requirement Changes
Medicare’s RACs (Recovery Audit Contractors) just received new contracts that change how they operate. In order to protect yourself, it’s essential that you firmly understand how these changes will affect you from being targeted for a RAC audit.
RAC Auditors are financially motivated to uncover every possible error on your Medicare claims. They get paid based on the compliance violations they identify. (Based on them collecting overpayments of over $2 Billion in just 2 years, you can bet they’re driven to find errors.)
Unfortunately, you can’t completely control whether you’re chosen for a RAC audit or not, but with a little help you’ll be better able to protect the specific areas of your practice that RACs will be targeting. But where are you going to get this insider information? That’s where former RAC Medicare Contractor Medical Director (CMD) Richard K. Baer, MD, can help…
Dr. Baer has put together a practical, 60-minute online training session on what these new RAC requirements mean to you. He’ll breakdown the key components of the new RAC contract in plain-English, and provide you with practical, step-by-step guidance on how you can better shield your practice.
- Stay away from RAC sweet spots that will get your practice targeted for an audit.
- Master the scope of the new RAC contract and what it means to your practice.
- Avoid wasting time beefing up services that RACs will no longer be focusing on.
- Protect yourself from the RAC audit microscope with documentation principles that work.
- Stop RAC audit penalties: Respond correctly based on the audit notice type (Automated, Semi-Automated, Complex).
- Speed up the audit process by responding to requests promptly, accurately and fully.
- Win a RAC audit appeal by pinning down exactly how they work, and preparing to go the distance.
- Draw the line on RAC audit requests by knowing what they’re really able to ask for and responding with the appropriate documentation.
- And so much more…
Dr. Baer was a Medical Director at Medicare for 20 years, and a Medicare Contractor Medical Director (CMD) for a RAC program for 6 years. Rarely do you get an opportunity to have someone with his experience and knowledge offer an insider’s view of such a complex system, and he wants to share it with you.
Remember, once you’re on a RAC’s audit radar, it’s only a matter of time before auditors come knocking on your door. Then, more often than not, they’ll find what they’re looking for, your money. Your only protection is to have a strong handle on the limits of the new RAC contract so you can stop unfounded requests, and head off serious financial penalties.
P.S. Dr. Baer’s talk will be best appreciated by providers and key staff that have at least some familiarity with RAC audits, but need not be experts. There will be a brief introduction to RAC activities for those newer to the topic.
Meet Your Expert: Richard K. Baer, MD
Dr. Baer provides consultant services on a wide variety of healthcare coverage, compliance, audit, coding, and billing services. Dr. Baer served over 20 years in medical director roles for the Medicare Administrative Contractor (MAC), the Recovery Auditor (RAC), and regional home health and hospice contractors. He most recently served as the Medical Director for the RAC, Region A, in the northeast US. He's located in Chicago, Illinois.
Dr. Baer consults on medical coverage of devices, drugs, and other items and services. He also consults on health care compliance services, including RAC audits, Medicare appeals work, and state and federal audits. He provides analysis for clinical research billing compliance and development of medicare coverage analyses for research protocols.
During his tenure with the Medicare program, Dr. Baer authored several hundred Local Coverage Determinations (LCDs) and other medical review policy articles and documents for new technologies, pharmaceuticals, and highly utilized services covering millions of Medicare beneficiaries. He has provided medical policy assistance to CMS on national coverage issues, and has been involved in federal investigations and audits of Medicare improper payments and fraud matters for a variety of health care providers. He has frequently served as an expert witness for the Department of Justice in Medicare civil and fraud cases.
Reviews:“The information is timely! The webinar provided a solid forecast of what to expect from the RAC now and in the near future.”
- Elizabeth Mahoney, Manager of Case Management, Sheridan Memorial Hospital, Sheridan, WY
- Mona Casey, R.N. Team Leader Utilization Management, Methodist Hospital, Omaha, NE