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Shining Light on Medicare Recovery Audits (RACs)

Association for Home & Hospice Care of N.C.

    Speaking Engagements
  • November 08, 2017

Raleigh partner Matt Wolfe detailed what home health providers need to know about Medicare recovery audits audits during a webinar hosted by the Association for Home & Hospice Care of North Carolina. He covered:

  • A brief background on the recovery audit contractors (RAC) for Region 5, as well as the overall scope of work and CMS expectations.
  • How agencies can be chosen for an audit and types of audits, including automated and complex, and how notification works.
  • ADR limits and how to send record requests, including what happens if records are not sent in.
  • RAC guidelines.
  • RAC automated and complex review work flows and important timelines, including how to utilize a discussion review and the appeal process.
  • Role of the Medicare administrative contractor (MAC) in review and appeals.
  • Risk of extrapolation and when to involve counsel.
  • What you can do now to prepare.

Matt also wrote a blog recently explaining how a federal lawsuit over a massive Medicare appeals backlog is impacting RAC audits. You can find that blog post here.