Shay Pratt on July 25, 2012 |
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Topics: Planning, Strategy, Market Trends, Payer and Regulatory Policy, Medicare, Reimbursement, Finance, Revenue Cycle
Last November, CMS announced an expansion to their Recovery Audit Contractor program called the Prepayment Review Demonstration Project. Unlike previous RAC efforts that retroactively reviewed claims for billing accuracy and appropriateness, the new demonstration would switch tactics to “prevent improper payments before they are made.”
CMS initially scheduled the demonstration, expected to more than double the amount of reviewable claims to 2.7 million, to launch on January 1, 2012, and targeted 15 inpatient DRGs, including spinal fusion and cardiac implant procedures.
Continue reading:
Medicare’s Prepayment Review Demonstration: Everything we know so far
