RAC 'Em Up

Baird, Jeffrey S.
February 2010
HomeCare Magazine;Feb2010, Vol. 33 Issue 2, p48
Trade Publication
The article focuses on the responsibilities of the Recovery Audit Contractors (RACs) in the U.S. It says that RACs are assigned to review and identify improper payments in the Medicare fee-for service program and are excluded from looking at claims for incorrect level of physician evaluation and management codes. Moreover, RACs are optional to have a medical director or certified coder staff during the demonstration project.


Related Articles

  • Stop Downcoding E/M Visits, and Add Minimum of $56 to Your Bottom Line.  // Internal Medicine Coding Alert;Feb2012, Vol. 15 Issue 2, p12 

    The article highlights the need for physicians to stop downcoding evaluation/management (E/M) visits to avoid losing huge amount of revenue in the U.S. It outlines the reasons to always file a claim based on physician's documentation while emphasizing the importance to choose accurate codes. It...

  • Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012.  // Part B Insider;Jan2012, Vol. 13 Issue 4, p25 

    The article discusses the Medicare claims processing in the U.S. It mentions that under the "Current Procedural Terminology" (CPT) in 2012, physician subspecialties are recognized in considering a new patient. It notes that despite this provision, Medicare does not improve its...

  • E/M Services Call for Modifier 25, But Only When Necessary.  // Medicare Compliance & Reimbursement;9/20/2010, Vol. 36 Issue 18, pp140 

    The article offers tips on the proper use of Modifier 25 in health insurance claims in the U.S. It mentions that Modifier 25 is only used for evaluation and management (E/M) services, hence, procedures that do not fall under E/M services qualify another modifier. It notes that the modifier...

  • Patient Wants Physical But Refuses AWV? Document Everything.  // Health Information Compliance Alert;Jan2012, Vol. 12 Issue 1, p5 

    The article provides an answer to a question regarding a miscoded health insurance claim in the U.S.

  • Follow These CMS Rules for Submitting Medicare Secondary Payer Claims.  // Podiatry Coding & Billing Alert;Jun2012, Vol. 4 Issue 6, pp44 

    The article offers tips related to Medicare Secondary Payer (MSP) claims in compliance to rules of the U.S. Centers for Medicare and Medicaid Services (CMS). It recommends that medical practices should inquire patients about their health insurers and suggests billing of primary payer first. It...

  • Double-Digit Cuts May Strike Your Income Starting in January.  // Dermatology Coding Alert;Oct2012, Vol. 8 Issue 10, pp76 

    The article presents information on the Medicare Physician Fee Schedule proposed by the U.S. Centers for Medicare & Medicaid Services (CMS) for 2013. The proposal states that if a physician in family practice spends a considerable amount of time providing care for patients going back to the...

  • Home Care Providers Win Leeway On Timely Filing.  // Eli's Home Care Week;8/16/2010, Vol. 19 Issue 29, p230 

    The article reports on the issued instructions from the U.S. Centers for Medicare and Medicaid Services (CMS) on how to count the 12-month time frame from Medicare claims' "From" date. It notes that the claims for durable medical equipment or supplies filed on 1500 form are not affected by the...

  • Part B MACs Now Using 'Predictive Modeling' of Claims to Catch Fraud.  // Medicare Compliance & Reimbursement;8/21/2011, Vol. 37 Issue 22, pp171 

    The article reports on the announcement by the U.S. Centers for Medicare & Medicaid Services (CMS) that Part B Medicare Administrative Contractors (MACs) is using predictive analyses to scan claims and to detect fraud. CMS has made an effort in streaming all Medicare FFS claims by its predictive...

  • Incorporate New ABN To Collect For Non-Covered Services Going Forward.  // Health Information Compliance Alert;Jan2012, Vol. 12 Issue 1, p1 

    The article presents an overview of incorporating new advanced beneficiary notice (ABN) in collecting non-covered medical services in the U.S. It notes that the mandatory use of the new version will take effect on November 1, 2 011. The importance of ABNs in helping patients to decide whether...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics