Posts Tagged pre-payment audit


RAC Prepayment Reviews – the Game is Changing: CMS Provider Call on August 9th

Medicare Fee-For-Service Recovery Auditor Prepayment Review Demonstration

Thursday, August 9, 2012

2:00PM – 4:00PM ET

Conference Call Only

The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the recently approved Recovery Auditor Prepayment Review Demonstration that will begin August 27, 2012.

This Special ODF is designed specifically for Medicare Fee-For-Service providers who may be subject to Recovery Auditor review in the 11 approved demonstration states: FL, CA, MI, TX, NY, LA, IL, PA, OH, NC, and MO. Recovery Auditors will review claims before they are paid to ensure that the provider complied with all Medicare payment rules. These reviews will focus on certain types of claims that historically result in high rates of improper payments. Initially, Recovery Auditors will review short stay inpatient hospital claims. This demonstration will also help lower the error rate by preventing improper payments, rather than the traditional “pay and chase” methods of looking for improper payments after they have been made.

During this ODF, CMS will provide an overview of the Recovery Auditor Prepayment Review Demonstration, including:


Posted in: Collections, Billing & Coding, Compliance, Medicare & Reimbursement

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