Payer Audits

Payer Audits

RAC Audit

RAC Audit Response and Appeal Survival Tactics

Although last year’s pandemic put a brief pause on Recovery Audit Contractor (RAC) audits — this year they are once again in full swing.  Auditors are picking up the pace to make up for lost time. So, your chances of getting audited are higher than ever before. What is a RAC Audit? RAC audits are […]
CPT telehealth audits

Ace Telehealth Audits and Keep Your Reimbursements

Important: Your CPT codes 99201-99215 claims are under attack. CMS and private payers started their telehealth exam post-payment audits which include reviewing your records and contacting your patients. Address these telehealth audit targets right now so you can hold onto more of your office visit pay and prevent future compliance penalties. Telehealth Exams Must Include […]
OIG Telehealth Audit

Audit OIG Report: 4 Ways to Avoid Telehealth Audit Traps

It’s now official: Your telehealth services are on CMS’ radar. The Office of Inspector General (OIG) just announced that it will start reviewing claims for specific violations. The last thing you want to do is pay back money for incorrect telehealth reporting. But that’s exactly what could happen if you don’t tighten up your telehealth […]
third-party payer appeals

6 Tips for Successful Third-Party Payer Appeals

When even the slightest mistake on a claim form can lead to a denial or reduced reimbursement, you need to be on your toes. The good news is with some leg work third-party payer appeals can get you paid more of what you are due. While third-party payer appeals are a time-consuming complex process, they’re […]
OIG Urine Drug Test

OIG Watch List: Protect Payments from Urine Drug Test Audits

The Office of Inspector General (OIG) added to its Workplan items that contractors will audit or evaluate with a more critical eye. If you bill for urine drug test or speech-language pathology services to Medicare beneficiaries, now’s the time to weigh your compliance risk and fix any issues. OIG Scrutinizes Urine Drug Test, Speech-Language Pathology […]
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