The Medicare Recovery Audit Contractor Program: A Survival Guide for Healthcare Providers

ISBN-13: 9781138431973 / Angielski / Twarda / 2017

Duane C. Abbey

Opis

Medicare fraud is big business, but while only a few profit from intentional malfeasance, the Centers for Medicare & Medicaid Services is now taking a closer look at everyone. This title explains all that is required to prepare and successfully defend against inappropriate RAC audit recoveries.

Recenzje

For many nurse leaders, understanding the mysteries of corporate compliance, the Office of the Inspector General, or the Department of Justice has been challenging to say the least. Dr. Duane Abbey has taken these topics and, specifically, the newest kid on the compliance block-the Recovery Audit Contractor (RAC) Program-and translated them into a very understandable language that nursing leaders can get their arms around, particularly in the surgical arena. … Although the subject is potentially intimidating, this book is a very engaging and understandable read for nurse leaders. As an experienced leader but one who is a novice in compliance matters, I found that the author provides this book as a tool kit to help leaders find the information necessary to proactively prepare for a RAC audit. The author does a great job of taking the technical language related to RAC audits and incorporating the use of storytelling to explain the important concepts in an understandable and engaging format. Not surprisingly, the author has more than 25 years of health care experience, with much of his time spent divided between teaching the concepts of billing and compliance and consulting with health care organizations.
—Maureen C. Chadwick, MSN, RN, NE-BC, Director, Peri-Operative Services, Saint Vincent Health Center, in the AORN Journal, May 2011, Vol. 93, No. 5

Spis treści

Acronym Listing. Introduction. Purpose, Structure, and Intent of the RAC Audit Program. RAC, OIG, and Medicare Audits. Brief Review of Healthcare Payment and Payment Systems. RAC Audit Issues. RAC Processes. Understanding the RAC Appeals Process. Meeting the RAC Audit Challenge.

O autorze

Duane C. Abbey