The six state medical societies of New England sponsored a
webinar to inform physicians and medical office staff about a
national auditing program that will impact health care providers.
This session described the national Recovery Audit Contractor (RAC)
program, a component of the Tax Relief and Health Care Act of
2006.
The goal of the RAC is to identify improper payments made on
claims of health care services provided to Medicare
beneficiaries. Improper payments may be overpayments or
underpayments.
Overpayments can occur when health care providers submit
claims that do not meet Medicare's coding or medical necessity
policies.
Underpayments can occur when health care providers submit
claims for a simple procedure but the medical record reveals that a
more complicated procedure was actually performed.
Health care providers that might be reviewed include hospitals,
physician practices, nursing homes, home health agencies, durable
medical equipment suppliers and any other provider or supplier that
bills Medicare Parts A and B.
Presenters included representatives from the Centers for
Medicare and Medicaid Services, and Diversified Collection Services
Inc., the contractor for the RAC program in New England.
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