tci Medicare Compliance & Reimbursement - 2014 Issue 8

Recovery Audit Contractors: Don't Double Dip with Hospital Visits

Tip: Incorrect coding will invite RAC scrutiny. If your doctor is billing for seeing an inpatient in the morning with an initial hospital care code and then again for seeing her in the afternoon with the subsequent care code, you’d better be ready for increased attention from at least one recovery audit contractor (RAC). Background: When CMS started the RAC program, the agency appointed four RAC contractors to implement it, and those companies must post new issues that CMS has approved them to investigate. These companies include Performant Recovery (Region A), CGI Technologies (Region B), Connolly Consulting Inc...

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