Find out how to keep your claims out of RACs' reach. Giving your claims a clean bill of health may be the best medicine for keeping the RACs off your case. Since RACs can request records going back three years, "the sooner a provider identifies its issues and corrects them moving forward, the better," says
Correction your best policy: "Whenever a hospice discovers that it has made a billing mistake, it should seek to correct the problem and make repayment," advises attorney Paula Sanders, partner with Post & Schell in Harrisburg, Pa.
And if the hospice thinks it has a systemic issue with billing, it should consult with counsel and decide whether a voluntary disclosure is the best way to proceed, Sanders counsels.
"If a provider does a self-audit, and identifies and self-reports the improper payments, those claims will be adjusted and excluded from RAC review," she adds.
This exclusion also applies to findings included in a self-disclosure, "as long as the Medicare Administrative Contractor confirms that a payment error exists and the sampling/extrapolation method was correct."