Efficient Coding and Billing Can Keep RAC Audit Fears At Bay

by | Published on May 13, 2013 | Medical Coding

Efficient Coding Billing
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There are a lot of myths and misconceptions among healthcare service providers about the functioning of the RAC (Recovery Audit Contractors). The RAC system was created to help CMS (Centers for Medicare and Medicaid Services) to identify improper payments by government insurance programs.

The AMA (American Medical Association) has pushed to introduce reforms to the fee structure, leading to many improvements. The AMA continues its efforts to reduce the load of the RAC audits on physicians.

In December 2012, CMS published a list of myths that physicians had about the functioning of RACs. The purpose of this publication was to dispel the fear and do away with the misconceptions about RAC auditors.

Accurate medical code is necessary to avoid RAC (Recovery Audit Contractors) audits. Other ways physicians and healthcare practices can steer clear of the unfavorable audit net are:

  • They can begin by auditing their billing or coding department, billing service, and third-party vendor. Billing and coding service providers would be glad to get their work audited, and if they are not, it could be an indication that something is wrong.
  • Avoid overcoding and undercoding. Overcoding would certainly lead to an RAC audit while undercoding can affect your revenues. A professional medical billing and coding company can help you avoid these undesirable issues.
  • Payers such as Medicare have separate guidelines to reimburse midlevel providers (MLPs). Practices that use physician assistants or nurse practitioners to provide patient care should be aware of these rules.

With reliable medical billing and coding services, there would be no reason for the healthcare facilities to fear RAC audits.  A professional service provider would have coding specialists with extensive and up-to-date knowledge of compliance with CMS requirements.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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