Description

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The RAC Toolkit for Physician Practices
Protecting Your Bottom Line Under Medicare's Recovery Audit Contractor Program

Elizabeth E. Lamkin, MHA

RACs are auditing practices. Learn how to prepare.

The RAC Toolkit for Physician Practices is your practice's answer to turning plans into proactive action for success during Recovery Audit reviews.

Authors Elizabeth Lamkin, MHA, and Amanda Berglund, MS, MBA, describe how to establish and sustain an effective RAC-preparedness structure that can be adapted to fit any organization's system. They provide best practices for successful processes and outline each staff member's role in your RAC audit program.

Physician practice settings are getting audited by RACs. Whether you are responding to a Recovery Auditor or another government auditor, your program must operate as effectively as possible. You will use their tested, proven, and practical tools that will help you build a more effective billing compliance program. You'll learn how to bring finance, business office and clinical staff together for operational improvements that directly affect your bottom line.

The RAC Toolkit for Physician Practices help you achieve the following goals:

• Take a systemic approach to RAC compliance
• Incorporate effective structure and processes to existing systems for measurable results
• Organize committees and facilitate information flow
• Appeal effectively and within deadlines
• Use proven tools and methods for an effective RAC program

Table of Contents

• About the Authors
• Introduction
• Chapter 1: RAC Overview
• Chapter 2: Preparing for RAC
• Chapter 3: The Right Structure--Organizing the Right Committees
• Chapter 4: Critical RAC Roles: Stakeholders and Roles for Prevention of Billing Errors
• Chapter 5: Automated Reviews
• Chapter 6: Complex and Semi-Automated Reviews and Extrapolation
• Chapter 7: The Appeal
• List of Acronyms

Among the tools you can download are:

• RAC appeal timeline
• RAC preparedness checklist
• RAC committee structure flowchart
• Organizational chart for RAC-related personnel
• Sample RAC committee meeting agenda
• Complex case review worksheet
• Automated review timeline
• Complex review timeline
• CMS form 20027
• CMS form 20034
• CMS form DAB101
• CMS form 20033

Who should read The RAC Toolkit for Physician Practices?

Coding supervisors, billing supervisors, practice administrators, practice managers, office managers, RAC coordinators, administrator coding/compliance auditors, compliance officers, compliance coordinators, coding supervisors, and coding specialists.

About the Author

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Elizabeth Lamkin, MHA, and Amanda Berglund, MS, MBA, are partners at Hilton Head, SC-based PACE Healthcare Consulting, LLC., which provides a broad range of strategic and tactical services for hospitals and healthcare providers.