CMS: RACs recovered $162 million in overpayments in 2011

The Centers for Medicare & Medicaid Services released new data on the amount of overpayments and underpayments collected by Recovery Audit Contractors (RACs) in the first quarter of 2011. The total overpayments collected during that time totaled $162 million while underpayments totaling $22.6 million were returned during that same timeframe. This marks a significant change from the last quarter (Oct. to Dec. 2010) in which CMS collected $75.8 million in overpayments and returned $13.1 million in underpayments.

The report also identifies the top issue for each RAC dating back to the beginning of the National Recovery Audit Program in fiscal year 2010. The highlighted issues surround hospital services. However, CMS separately publishes a quarterly newsletter intended to help health care providers understand the top billing errors identified by Medicare contractors. In the current newsletter, CMS describes several problems RACs have found that affect physicians, including:

• Incorrectly billing for new patients
• Evaluation and management (E/M) billing during global surgery procedure
• Chemotherapy administration and non-chemotherapy injections and infusions- correctly billing

In addition to these problem laid out by CMS, the agency is also aggressively seeking out improper payments using other contractors.

Dallas L Alford IV, CPA is a licensed Certified Public Accountant in the state of North Carolina and owner of Atlantic Financial Consulting, a consulting firm that provides comprehensive medical billing services, practice management consulting, coding audits, Medicare compliance, Medicare RAC support and other general medical practice consulting services.
To learn more about Atlantic Financial Consulting you may visit their website at http://atlanticfinancial.us or contact Dallas L Alford IV, CPA directly at 1 888-428-2555 begin_of_the_skype_highlighting            1 888-428-2555      end_of_the_skype_highlighting, Ext. 200.