BC Advantage - 2009 Issue 11

Medicare Auditors: What they're looking at, and why

The industry is buzzing with news of Recovery Audit Contractors (RAC), and even word of period Comprehensive Error Rate Testing (CERT) drifts by now and again. But there are many other oversight entities that are conducting audits as well. Conducting internal and external audits reduces or eliminates fraud and waste, and is an important way to keep healthcare costs under control. HHS has estimated that for every $1 it spends to stop fraud, it saves $1.55, according to a May, 7, 2009 news release. There are four main areas that HHS and government contractors are continually auditing and...

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