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According to CMS's January 2009 Update to Evaluation of the 3-Year Demonstartion, the RACs succeeded in collecting more than $1.03 billion of overpayments from providers in the demonstration states. This is money CMS recovered from facilities like yours.
In addition to recovering overpayments, CMS "prevented a significant amount of improper payments by denying $1.8 billion in claims prior to payment."
Providers appealed 22.5 percent of RAC determinations with only 7.6 percent being overturned on appeal for Part A and B claims combine.
Is your facility RAC ready?
Amphion Medical Solutions provides expert services in data mining to identify those MS-DRGs on your RAC's focus list that present the greatest financial risk to you. Amphion's pre-billing intervention (PBI) services include continuous pre-bill review of the targeted MS-DRGs to ensure your coding is accurate before you drop the bill.
Our PBI services allows you to focus your internal resources on implementing the necessary process changes to retain your claims dollars while taking advantage of Amphion's objective expertise in identifying your exposure for coding compliance in the RAC focus areas.
Amphion also provides expert MS-DRG denial appeal services. Our professionals have extensive experience in this area from prior employment with state QIO's and the American Hospital Association. Contact us to work with your facility to construct appeal letters that will challenge inappropriate RAC denials.
Do not let compliance pressures stop your reimbursement.
Click here to contact us!
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