RAC Appeals and Reports to Congress

In the previously mentioned article on CMS Manual System changes, I touched on the fact that you need to be organized.

There is a second part to that CMS Manual change, and it deals with Monthly Appeals Reports and the proper method a RAC is to follow when they submit those reports.

About a year ago, I gave a presentation at a regional health meeting about HIPAA.  Prior to my speaking, there was a quick Q & A about a thing called a RAC Audit. I listened in shock as person after person described their method of tracking demand letters and files.   I heard spreadsheets, post-it notes…you name it.

When I got up to speak I couldn’t begin on my subject until I clarified a few items.  The first thing I did was ask: “how much time do you spend tracking this information?”

My answer wasn’t anything specific, but what occured was a low rumble, a murmur of gripes and complaints about how much time they spent.

My next question was: “how much value do these files have to your practice?”

That answer was much more specific as nothing less than “thousands of dollars” was yelled out.

I scribble a few notes to myself…and myRACTracker was born.

Here is the problem: as with almost all government programs, the RAC program is anything but simple.

And just like an insurance company, the last thing the RAC program wants to do is make it easy for a provider to appeal and KEEP their money.

For something as important and valuable as these files to be tracked on a spreadsheet or some other willy-nilly way shook me to my core.

Now we see the CMS want RAC’s to submit spreadsheets of appeals data to be used as reference for reports to Congress…SPREADSHEET!

There is mention in the manual update that this is until the RAC Data Warehouse is capable of tracking appeals, then they’ll “just” have to update that system instead.

These spreadsheets are going to be a confusing disaster.  It will probably take at least 2 full time employee at each RAC to generate these spreadsheets.

This is important stuff, and if you treat it like any other “thing” that needs to be followed, you are going to loose big time.

There are so many time line requirements to keep track of, you will lose your mind.

Nobody on the CMS side is looking to make this easy for you.

We are.

MyRACTracker.com will return sanity to your life, reduce the stress of your staff and let you actually see the value of the files the RAC’s request of you.

Not only will you be able to easily track everything RAC, you’ll be able to look at the system and instantly see how much money you have on the line.

You’ll see:

  • Total value of all files in review
  • Total amount of money recouped by the RAC
  • Total amount you have prevented the RAC from taking
  • There is much more to it, but money is really what this comes down to

Be smart and get on the waiting list to be a myRACTracker.com user.

RAC Here to Stay

In a recent post on the American Academy of Neurology site (the story), the Academy states the obvious:

Recovery Audits are here to stay.

It doesn’t take a genius to look at the test period and see that any been counter would go full bore on this project.

Probably the only reason the HHS hasn’t torn into Recover Audits any quicker is lobbying by physician & hospital associations.