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audits

Performant ready to roll

 - 
03/10/2017

LIVERMORE, Calif.

New RAC posts new reviews

 - 
02/24/2017

WASHINGTON – Performant Recovery, the new national recovery audit contractor (RAC) for DMEPOS and home health/hospice, has posted seven new reviews on its workload page, according to AAHomecare.

Expect audits to get more aggressive

 - 
01/27/2017

atlanta – When ZPIC auditors come calling, it’s important not to throw up your hands in surrender because there’s too much at stake, said healthcare attorney Ross Burris.

CMS contractor expands phone demo

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11/04/2016

JACKSONVILLE, Fla. – C2C Innovative Solutions, the contractor handling the second level of the Medicare appeals process, has received the green light from CMS to expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.

New RACs and new rules

 - 
Wednesday, November 2, 2016
Elizabeth Hogue
attorney

CMS has selected five new recovery audit contractors (RACs) and established new rules. RAC audits will undoubtedly resume soon. Performant and Cotiviti were awarded contracts, along with HMS Federal Solutions.

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CMS taps Performant for nat’l RAC for DME

 - 
11/02/2016

WASHINGTON – CMS has tapped Performant Recovery to perform post-payment reviews of Medicare claims for DMEPOS and home health/hospice nationwide.

Reporter's notebook: Right hand, left hand

Cover yourself in more ways than one, says Greene
 - 
07/25/2016

As if the sheer quantity of audits wasn’t enough to contend with, HME providers often have to untangle inconsistencies in regulations and guidance, says Stephanie Morgan Greene, a healthcare attorney who’s executive vice president of business development for AC

CMS revises scope of review on redeterminations and reconsiderations

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05/13/2016

WASHINGTON – CMS has expanded the limits on the scope of review for redeterminations and reconsiderations to include complex prepayment audits, AAHomecare has announced.

GAO pokes holes in CMS’s MA audit program

 - 
05/10/2016

WASHINGTON – The Government Accountability Office isn’t pleased with CMS’s progress in recovering substantial amounts of improper payments from Medicare Advantage organizations.

Audits: Use two-tier approach

Q. We received our audit results, which include a large amount of money owed to Medicare based on an extrapolated overpayment! What do we do now?
 - 
04/20/2016

A. To reduce or remove the extrapolation, you will need to appeal the overpayment determination, addressing both the individual claims reviewed in the audit and the extrapolation itself. Consider this a two-tier appeal process.

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