Healthicity Blog

Welcome back to our RAC blog post series. In this installment we’ll cover how to conduct a RAC Audit Risk Assessment.

Welcome back to our RAC blog post series. In this installment we’ll consider some of the ramifications for the CMS enhancement and expansion of the RAC program.

In our last blog post we talked about the inception of the RAC program. In this blog post we’ll cover expectations for 2016 and some enhancements and expansions to be aware of.

The use of electronic health records (EHRs) is steadily increasing due to incentives and the promise of a more efficient system. High-level evaluation and management (E/M) services are also increasing.

The RAC program has been controversial ever since its inception when the Centers for Medicare and Medicaid Services (CMS) instituted the program to identify and correct Medicare improper payments through the detection of overpayments and underpayments made on healthcare claims.

As with most professions, medical coding takes a special kind of someone. Ideally a someone who is fun on the inside but sticks to the rules when it comes to their 9-5. A great coder must be educated in the field, dedicated, and someone who loves to learn.

Getting the most out of an E/M audit can be as simple as paying extra attention to common coding and documentation errors, common exam mistakes, and Medical Decision Making (MDM) mistakes.

"A Code of Conduct is fundamental to a successful compliance program because it articulates the organization’s commitment to ethical behavior.”