Loophole allows low volume Medicare providers exemption from auditing
By
Kristin Walter
Dec 15, 2017
The current implementation of Medicare’s sliding scale ADR limit policy is preventing the recovery of improper payments and has afforded a significant portion of providers with immunity from billing...
Why is it so easy to ignore Medicare improper payments?
By
Kristin Walter
Oct 28, 2015
Recovery auditors corrected more than $2.57 billion in improper payments for FY 2014 – representing 5% of the $46 billion in wasted taxpayer dollars the program lost in a comparable period to fraud,...
Providers suffering Medicare appeals backlog — at their own hand?
By
James M. Berklan
Apr 29, 2015
If providers were charged a fee for challenging Recovery Audit Contractor findings, there wouldn’t be the current overwhelming backlog of Medicare appeals, says the administration — and, surprise,...
What’s in a name?
By
Tara Roberts
Mar 04, 2015
The new name of the American Coalition for Healthcare Claims Integrity is the Council for Medicare Integrity. Does that mean they’ll change their focus? Not quite.
Fuzzy math in RAC audits
By
Tara Roberts
Dec 15, 2014
If you are like me and have children who are required to contribute to science fairs, then you understand that the method in a science project is as important as the topic .It is difficult to explain to...