Catalog Number : cca1575
Title : Understanding the Medicare RAC Program
Speaker : Duane Abbey

Webplay Recording Date : 4-30-2009
Webplay Price : $ 150 for two weeks viewing

Webinar Overview:

This workshop address the current status of the CMS Recovery Audit Contractor (RAC) program that is a pilot program under Medicare. The various coding/billing areas that are being addressed in the pilot program are discussed as well as CMS’s future plans to expand this program.

Target Audience:

• Chief Compliance Officers
• CBR Compliance Officers
• Healthcare Auditors
• Healthcare Compliance Personnel
• Chargemaster Coordinators
• Billing and Claims Generation Personnel
• Patient Financial Management Personnel
• Cost Accounting Personnel
• Cost Report Personnel
• Financial Analysts
• Managed Care Contract Personnel
• Revenue Enhancement Personnel
• Chief Financial Officers
• Chief Compliance Officers
• Financial Planners
• All Other Hospital Personnel Interested in Compliance

Prerequisites for Participating:

A general understanding of health care compliance, OIG Work Plan and coding, billing and reimbursement compliance.

Webinar Objectives:

• To Provide and Overview of the Medicare Recovery Audit Contractor Program
• To Review The Establishment of the ‘Recovery Audit Contractor’ Program (RACs) and Findings from the Pilot Program
• To Assess the Current Activities and Implementation Status
• To Review the Data Mining and Auditing Processes used by Recovery Audit Contractors
• To Understand the Various Areas for Auditing Activities
• To Appreciate CMS’s Plans for Expansion of The Recovery Audits, Physicians, Clinics and Other Health Care Providers
• To Discuss The Ways in Which Hospitals and Clinics Can Prepare for Recovery

The following are a few of the topics to be discussed:

• CMS RAC Program
  • MMA Section 306
  • Objectives of the RAC Program
  • Demonstration Program - New York, Florida and California
  • Scope of RAC Program
• Current Status of RAC Program
• Operation of the RAC Program
  • Process and Procedures Used in the RAC Program
  • Overpayments versus Underpayments
  • Recoupment of Payments
  • Payment to RACs
• Typical RAC Program Audit Areas
  • Hospitals
  • Physicians/Clinics
  • Others
• Preparing for RAC Program Audits
  • Problem Area Identification
  • Integration into Current Audit/Review Programs
  • Impact on Coding, Billing and Reimbursement Audits
• Sources for Further Information

Attendance Certificate:

Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.