Understanding RAC

Recovery Audit Contractors, also known as RAC, is a program that seeks to identify and correct improper payments for services provided to Medicare Parts A & B beneficiaries.  This includes both recoupment of overpayments and corrected distribution of underpayments made by CMS.   RAC began in 2005 as a three-year demonstration project consisting …

Billing Requirements for Medicare Secondary Payer (MSP) Provisions

MSP provisions apply to situations when Medicare is not the beneficiary’s primary health insurance coverage. Before you submit a claim, you must determine whether Medicare is the primary or secondary payer for all inpatient admissions and outpatient encounters, thereby assisting in ensuring the appropriate use of Medicare funds. If another …

Patient Electronic Access Tipsheet – Measure Compliance

MEASURE COMPLIANCE – Meeting the Patient Electronic Access Objective
Starting in 2014, CMS requires that providers participating in both Stage 1 and Stage 2 of the EHR Incentive Programs must meet the Patient Electronic Access objective, which gives patients access to their health information in a timely manner. Providers participating in …