What can providers and facilities learn from this report

Reference no: EM133371732

Case Study: This chapter discusses how payers identify claims that were improperly submitted for payment. The Recovery Audit Program was implemented by CMS to identify and correct improper payments.

In the Recovery Auditing in Medicare for Fiscal Year 2015 report, the National Recovery Audit Program reports that the RACs collected 440.69 million in improper payments. This figure has drastically decreased since 2014, where the monies recovered by RACs totaled 25.7 billion.

Review the RAC 2015 Report to Congress located at:

Questions: Answer these questions listed below.

Evaluate why are facilities and providers are unable to prevent the improper claims that the RACs have identified in their reviews?

Determine what can providers and facilities learn from this report?

Determine what key points can be identified and then implemented at the coder, physician, and clinician level to improve reporting processes?

Reference no: EM133371732

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