Profast Billing Solutions announced the launch of a new service for physicians, home health agencies, hospitals and durable medical equipment providers in preparation for the upcoming Medicare audit by the RACs.

"The RAC audits are a big issue right now in the medical community," said Jeff Roh, co-owner of Profast Billing Solutions. "Anyone who files claims with Medicare probably has at least a little bit of concern about what the RACs might find when they audit their practice. The RACs are compensated to find errors, so you can be sure they will be aggressive. Even a little technicality could end up costing a physician thousands of dollars. That's where we can help."

A detailed, comprehensive base-line audit in advance of the RAC is intended to assist the provider identify and correct errors in the current billing and coding, and to make recommendations for areas of improvement. By catching errors well in advance, a practice can save thousands of dollars in Medicare overpayments.

Profast Billing will do an audit of a random sample of patient files. Audits are done by certified coders who have extensive experience in coding as well as government audits. The company has a page set up on their website with details of how the process works and what is needed, along with Frequently Asked Questions and contacts.

"The cost of doing a review independent of the Medicare RACs is minimal when you consider that not knowing what the audit contractors are going to find could cost you thousands," Jeff Roh said. "What's more, around 15% of the providers out there may find that they are being underpaid by Medicare due to improper coding. Believe it or not, Medicare is not only looking to recover money, but to pay back underpayments as well."

Profast Billing Solutions is a medical practice management company specializing in improving the cash-flow of medical practices. You can learn more about the Medicare audit at profastbilling.com

There is a lot of talk out there on blogs and article posts by physicians regarding the Medicare RAC audits that will be starting in full force soon. Is the RAC audit a big deal? You bet! The majority of physicians may have a good handle on their billing and coding, and the vast majority of physicians do not commit fraud. They may think they are safe from the CMS RAC audit...but think again.

All would be good and well if they were just looking for instances of fraud, abuse, or sloppy coding. But keep in mind, they are compensated to find errors, and even a small technicality may wind up costing you thousands of dollars. Medicare states that you can challenge the RACs findings, but if you've ever dealth with the appeals process, you know how that can be.

For a good opinion and more information, you can go to the article "When Fraud isn't Fraudulent" here.

A good way to protect yourself and potentially save your practice thousands of dollars is to catch any errors well in advance of the RAC audit. An independent third-party review by a qualified company is an excellent choice. For more information, click here.

Labels: cms audit, medicare audit, rac audit

Join us for a Webinar on March 6

Space is limited. Reserve your Webinar seat now at: https://www2.gotomeeting.com/register/255352187

This 30 minute live presentation can help you get the cash flow in your practice where it needs to be. Patrick Phillips, author of the new book, "Cash Crunch to Cash Flow," will show you why you are pocketing much less than you could be, even with your current patient base. He will discuss how to plug the hidden leaks that are draining profits from your practice. And, if you are an office manager or in charge of the receivables, you will have your eyes opened. Spend LESS time on the cash flow and yet see it increase two to three times what it is right now for the practice. Seats are limited, so reserve one now. You will be able to listen on your computer, or over the phone, and will see the presentation live on your computer screen. Note this is at 1:00 pm CENTRAL time, so adjust for your time zone: 11:00 am Pacific 12:00 noon Mountain 1:00 pm Central 2:00 pm Eastern Title: How Medical Providers Can Get More Money, Faster, Into Their Practice Date: Friday, March 6, 2009 Time: 1:00 PM - 1:30 PM CST After registering you will receive a confirmation email containing information about joining the Webinar. System Requirements PC-based attendees Required: Windows® 2000, XP Home, XP Pro, 2003 Server, Vista Macintosh®-based attendees Required: Mac OS® X 10.4 (Tiger®) or newer

So you got the notice...the Medicare RAC is coming to your practice. No big deal? Think again. The Medicare audit
of all beneficiaries of Medicare payments ( i.e. - those who file claims with Medicare ) is here to stay and if your
practice is out of compliance, it could end up costing you thousands of dollars. It's not all gloom and doom, however.
Follow a few simple steps to help get your practice prepared.

First, a little about the RAC. In 2005 Congress authorized the Recovery Audit Contractor (RAC) program to do a demonstration
in California, New York, Florida and 3 other states. The purpose - to discover areas of fraud and waste and recover overpayments made by Medicare
due to improper coding and compliance with Medicare guidelines. The result - over $900 million in overpayments recovered and returned
to the Medicare Trust Fund. With the success, Congress authorized the RAC program to be rolled out to all 50 states and Puerto Rico
no later than January 1, 2010.

Don't expect it to go away either...this program is to be permantely in place.

Anyone who files claims with Medicare, physicians, hospitals, home health agencies and durable medical equipment providers are all affected. What does this
all mean to you? If you fall into one of the above categories, expect a notice soon from the contractor in charge of the audit in your region. Don't expect
them to tell you what they are looking for, however. That is left up to you. The RACs are compensated on a contingency basis based on the amount of
overpayments that they find. You think they are going to be aggressive? You betcha! The penalties for overpayments? At the very least, overpayments
will have to be returned. And Medicare isn't going to send you an invoice and wait for the money...they will just take a portion of your current and future
claims payments until the overpayment is paid in full. In extreme cases, Medicare may suspend a practices claims privileges all together.

Protect yourself by following a few easy procedures.

First, consider conducting an internal assessment of submitted claims to make sure they follow Medicare guidelines. Either you, your staff, or a third-party
auditor can do this. However, a qualified third-party auditor may be the best option as this allows for someone outside your practice to give you a second
opinion. If you do choose to do it yourself, look for claims that have been denied in the past and and review the RAC's website.

Consider having a certified coder review a sample of your files and help you identify any pattern of inconsistent or improper coding. Again, a third-party audit
service is an excellent option. A qualified auditor should have certified coders on staff, preferably with governemt auditing experience as well.

Comply with Medicare's request for medical records in a timely manner. Failure to do so may cost you the right to appeal any decisions by the RAC that you disagree with.

Finally, implement corrective actions to ensure compliance with Medicare guidelines prior to the RAC visit to your office. The sooner you do this, the less money you
will cost yourself when the RAC finally gets around to you. If you choose to use a third-party auditor to assist you, they should provide you with a report on areas
for improvement as well as consult with you on other areas of compliance as well.

With the right preparation and implementation of processes, you don't have to fear the RAC. Besides, some good may come out of your audit. During the same demonstration
in the above mentioned states, $38 million in underpayments to providers was made. You may find areas where you have been underpayed, so it isn't all bad news.

For detailed information about the RAC you can visit the official Medicare website at www.cms.hhs.gov/RAC.

To learn more about our independent base line audit to prepare you for the RAC, go here.

Labels: cms audit, medicare audit, rac audit