In 2018, RAC auditors collected approximately $73 million—a reportedly low point for the RACs and a low point for collections. As a result, CMS has upped the criteria for RAC auditors. CMS now requires RAC auditors to maintain a 95 percent accuracy score which, technically is considered impossible with the current roster of RAC auditors. And that is because most have never provided any healthcare service. Against this backdrop, CMS has also started to withhold contingency fees until after the second level of appeal is exhausted. The second level of appeal involves a Quality Integrity Contractor (QIC) and the QIC is not, by most standards, considered to be an impartial tribunal.
The third level of an appeal involves the Administrative Law Judge (ALJ) and this is the venue where actual legal, due process occurs.
So, while CMS is holding RACs to a higher standard, this is the time for you to appeal. The cards are stacked against the RACs.
Why This is Relevant:
There is a flurry of audit taking place and now with the RACs being held by CMS to achieve a 90 percent accuracy rate, you can expect the RACs to be more aggressive and accurate in denying your claims. To stay ahead and protect your revenue this webcast is a must-attend event.
By attending this RACmonitor webcast, led by healthcare attorney Knicole Emanuel, you will…
- Learn about the most current issues with RAC auditors;
- Understand the CMS position regarding the RAC auditors;
- Learn about and gain an understanding about your appeal rights;
- Discover how new case law favors providers; and
- Learn the difference between Medicare & Medicaid Appeals.
Who Should Attend:
CFOs, in-house counsel, RAC coordinators, appeals specialists, compliance professionals, case managers, UR staff, chief medical officers, and physician advisors.