tci Medicare Compliance & Reimbursement - 2009 Issue 6

IN OTHER NEWS ...• Wondering how the new Recovery Audit Contractors plan to review -- and possibly deny -- your claims from afar?

Now you have part of the answer.The RAC for 17 states, Las Vegas-based HealthDataInsights Inc., will use Milliman Care Guidelines "content and software" to review Medicare claims, Milliman says in a release. "The Care Guidelines promote healthcare quality by providing clinical guidelines based on the best available clinical evidence," the Seattle-based company says. The company provides guidelines for seven topic areas including home care and chronic care. The Care Guidelines include quality measures and "each guideline topic outlines key issues, and provides details on clinical interventions to improve patient outcomes," Milliman says.• With the recovery...

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