HMS Blog: 2012 Year In Review

The HMS Blog kicked off in 2012 receiving 12,000 visits from 92 countries and more than 800 followers in 12 short months.

In addition to providing the latest news, information and trends in healthcare, we offered several series on hot industry topics in 2012 including RAC Audits, Care Transitions and Healthcare Social Media.  Our in-depth coverage of the health reform ruling and insight into the impact of the decision were highlighted in our series Understanding Health Reform, while our Post Election Guide to Health Reform provided an overview of provisions already being implemented and its benefits to consumers.

We’re already working on new and exciting material to bring you in 2013!  Don’t miss another minute of it! Follow the HMS blog today!

HMS Presents Medicare Audits & Appeals Program

Yesterday, HMS Healthcare Management Solutions presented Medicare Audits & Appeals to members of the Home Care Alliance of Massachusetts. The program clarified the various Medicare audits agencies may be experiencing as well as how to prevent and appeal denials.

HMS Director of Home Care and Hospice Services, Cheryl Leslie, gave an overview of how overpayments and fraud are discovered within the system and explained the importance of corporate compliance programs to target risk areas and anticipate audits. HMS Director of Consulting & Regulatory Affairs, Pam Meliso, highlighted the types of Medicare audits, the agencies and contractors who conduct them and strategies for appealing their decisions. The program concluded with a panel discussion of area agency administrators discussing RAC audits, tips for preparing for an audit and keeping records in order.

HMS recently offered a RAC Audit Blog Series to help sift through the who, what, when, where, how and why? of RAC audits from demand letter to appeal.  Given their aggressive nature, health care providers should consider a consultation to protect their interests. The experienced team at HMS Healthcare Management Solutions can assist and prepare your agency.  Contact us today to find out how we can help.

RAC Prepayment Demo Slated For August 27

The Centers for Medicare & Medicaid Services (CMS) announced a demonstration project using Recovery Auditors (RACs) to perform prepayment review is set to begin on August 27.

The demonstration, set to take place in 11 states, will review certain types of claims prior to payment. More specific details about this demonstration are available on the CMS website.

HMS Healthcare Management Solutions can help with RAC audits.  Find out how by contacting us today!

Click here to read more.

Appealed RAC Claims Favored Provider in 2011

In FY 2011, hospitals and other providers appealed 56,620 claims, or 6.3%, of the 903,372 that had overpayment determinations from Medicare Recovery Auditors (RACs).  According to a RAC Program appeals update issued by the Centers for Medicare & Medicaid Services (CMS), 43.4% received a ruling in the provider’s favor.

Click here to read more.  For help with RAC audits, contact HMS Healthcare Management Solutions to find out how our experienced team can help.  Contact us today!