New Book Shows How to Prepare for RAC Audits

Feb. 25, 2010 - PRLog -- The Centers for Medicare & Medicaid Services (CMS) launched an aggressive new program to detect fraud, waste and abuse in Medicare claims.  The first part of the program which included four test states was so successful, that the program was expanded to include all 50 states in 2010.  Commonly known as RAC Audits (Recovery Audit Contractors), the program is designed to look behind every claim, billing trend and patterns across Medicare provider.  By enhancing their oversight efforts, Medicare can better ensure that the dollars are being used to pay for equipment or services actually used by beneficiaries while protecting the Medicare trust fund from unscrupulous providers and suppliers.  

This book written by medical billing guru and lean accounting expert, Duane Abbey, The Medicare Recovery Audit Contractor Program: A Survival Guide for Healthcare Providers explains all that is required to prepare and successfully defend against inappropriate RAC audit recoveries. Using the same succinct style that always makes his writing so palatable, Abbey illustrates his lessons with simple case studies placed in the context of a fictitious community whose population is served by a hospital, clinics, a nursing facility, and other providers all seeking to maintain compliance and profitability.

In discussing RAC guidelines, this resource —
•Shows how to identify overpayment areas and associated compliance issues
•Details a systematic problem-solving process relative to RAC processes
•Addresses resource requirements including new personnel, such as RAC specialists
•Includes planning models for developing compliance departments
•Provides an extensive glossary to make sense of medical billing’s alphabet soup of acronyms

While the book works well as a stand-alone reference for those seeking advice on RAC audits, readers will also discover that this volume extends the lesson of Abbey’s classic Coding, Billing & Reimbursement , making this book a natural companion  for those wanting to fully explore the role of Lean accounting in medical billing.

About the Authors

Duane C. Abbey, PhD, CFP, is a management consultant and president of Abbey & Abbey Consultants, Inc.  Based in Ames, Iowa, Abbey & Abbey specializes in healthcare consulting and related areas.

Dr. Abbey, whose work in healthcare now spans more than 25 years, earned his graduate degrees at the University of Notre Dame and Iowa State University.  Today, he spends about half his time developing and teaching workshops (for students who affectionately quip that the Federal Register is his favorite reading material) and making presentations to professional organizations.  He devotes the other half to consulting work that involves performing chargemaster reviews, compliance reviews, providing litigation support, and conducting reimbursement studies.

Dr. Abbey also uses his mathematical and financial background to perform financial assessments, develop complex financial models, and conduct various types of statistical work.  His studies in the field of neurolinguistic programming have enhanced his ability to provide organizational communication facilitation services for healthcare organizations.  He also provides litigation support services for attorneys representing healthcare providers in legal proceedings.

About Productivity Press
Productivity Press is the premier source of authoritative information on organizational improvement, offering the broadest selection of books and learning tools about lean methodologies, based on the Toyota Production System. Our health care product line is a primary source of leading-edge publications, workbooks, tools, and resources to improve the overall performance and quality of the healthcare system. For more information visit our website at ProductivityPress.com. Productivity Press is a division of The Taylor and Francis Group, www.taylorandfrancis.com.

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Productivity Press is a premier source of authoritative information on organizational development offering the broadest selection of books and learning tools about lean methodologies, based on the Toyota Production System. www.productivitypress.com