The six state medical societies of New England sponsored a webinar to inform physicians and medical office staff about a national auditing program that will impact health care providers. This session described the national Recovery Audit Contractor (RAC) program, a component of the Tax Relief and Health Care Act of 2006. 

The goal of the RAC is to identify improper payments made on claims of health care services provided to Medicare beneficiaries.  Improper payments may be overpayments or underpayments.

• Overpayments can occur when health care providers submit claims that do not meet Medicare’s coding or medical necessity policies.
• Underpayments can occur when health care providers submit claims for a simple procedure but the medical record reveals that a more complicated procedure was actually performed.

Health care providers that might be reviewed include hospitals, physician practices, nursing homes, home health agencies, durable medical equipment suppliers and any other provider or supplier that bills Medicare Parts A and B.

Presenters included representatives from the Centers for Medicare and Medicaid Services, and Diversified Collection Services Inc., the contractor for the RAC program in New England.

Listen to the Question & Answer Session:

Answers were provided by Ebony Brandon and Gia Lawrence from the Centers for Medicare and Medicaid Services, and Catherine Till from Diversified Collection Services.

Listen to the podcast (Length 36:17) (This will open your computer's default media player in a new window)

Download from iTunes

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