The centers for Medicare, and, Medicare services, has raised the bar, for health care providers nationwide in reporting and maintaining unambiguous and updated medical billing records. According to reports by the Government Accountability Office (GAO), several billions of dollars are lost due to over payment, fraudulent claims and abuse every year.
To curtail the amount of money wasted and lost, CMS is adopting recovery audits or RAC as they are most commonly known, to motivate healthcare providers in helping to create and sustain more accountable, evidence based, and, streamlined healthcare services.
How RAC can impact your practice?
The primary focus of RAC auditors or recovery firms is to identify overpayment of medical bills. Most hospitals especially small scale medical practices have insufficient staff and resources to maintain proper documentation of billing records. This could result in their billing claims and insurance payments to come under the RAC scanner and having to pay a heavy price for overpaid or inappropriate claims and also as the worst case scenario, face medico legal action.
Avoid the tripwires
Responding swiftly to additional documentation requests from the RAC can ensure that you’ve avoided the first and most critical pitfall. To provide timely ADR you must have proper and extensive documentation in place. This requires additional man power and billing staff who are clued in to every phase and detail of the billing cycle. To avoid RAC auditing scares maintain systematic and date-wise details of your billing claims and accounts receivables.
One step ahead can go a long way!
Instead of panicking and losing sleep over CMS audits take it one step at a time and set your record straight, literally and figuratively. Brace yourself for rejected ADR claims and appeals but the best possible way to avoid hassles, dangers and hurdles that can come with improper or insufficient medical billing documentation, outsource your billing process to professional medical billing firms.
You can save on time and resources by working with a medical billing firm that can take care of your billing and auditing needs while you take care of your patients!