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Rheumatology practices should begin working on a compliance plan for self-audits on documentation. In an effort to prepare practices for the tremendous work ahead, the ACR has various programs in place to assist physicians and their staff in understanding the documentation and coding guidelines through face-to-face presentations at state society meetings, chart reviews, and the Rheumatology Coding Manual (available at www.rheumatology.org/publications). Also, don’t miss the practice management session, “RAC & Roll,” at the ACR/ARHP Annual Scientific Meeting in Chicago. This session will provide attendees with specific information on identifying key risk areas that are under the microscope of the RAC and how to prepare and survive any audit.

Have questions about the CMS RAC program and how it might affect your practice? Want to know what the necessary elements to meet documentation requirements are? Contact Melesia Tillman, CPC, CRHC, CHA, ACR coding and reimbursement specialist, at [email protected] or (404) 633-3777, ext. 820.

What you need to know about the Recovery Audit Contractor program

For a provider of healthcare services, payer audits are always a possibility. Both government and private payers consistently monitor providers to prevent fraud, overpayment, and improper billing or coding procedures. Audits can be nerve-racking and intimidating, even if a provider is billing correctly. Improper billing can lead to civil and criminal sanctions. To alleviate some…

Both government and private payers continue to aggressively monitor providers to prevent and recover overpayments. This is evidenced by the fact that the number of audits conducted in recent years has increased dramatically. A negative audit finding can result in the need to repay five- or seven-figure amounts. Types of Audits Private Payer Audits Private…

The ICD-10 page on the Centers for Medicare & Medicaid Services (CMS) website features a countdown clock that shows the time left until Oct. 1, 2015, the date on which compliance with the new code set becomes mandatory. By the time this issue goes to press, the clock will read 90 or fewer days. Time…

Medicare Bills Under the Magnifying Glass

Different Payer Audits Require Different Preparation & Response

What Rheumatologists Need to Know about Payer Audits

Prepare NOW for ICD-10 Medical Coding Transition

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