Tag: rac audit

CLMA Asks Labs for Examples of RAC Auditor Overreach

STORIES ABOUT HOW PRIVATE MEDICARE AUDITORS are overreaching in their zeal to identify fraud have caught the attention of the U.S. Senate Finance Committee. It is asking providers to submit examples of overzealous RAC auditors.

For its part, the Clinical Laboratory Management Association (CLMA) is collecting examples of recovery audit contractor (RAC) auditors behaving badly when

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Changed Medicare Policy Adds to Regulatory Risk

CEO SUMMARY: When Medicare’s National Correct Coding Initiative (NCCI) manual took effect on January 1, 2012, it contained a significant change in how prostate biopsy claims are to be coded. This change was widely overlooked by the pathology profession and even dismissed entirely for its ambiguity and inconsistency with previously published guidance on the subject.

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How One Pathology Group Survived Its First RAC Audit

CEO SUMMARY: Last summer, InCyte Pathology in Spokane, Washington, found itself facing demand letters from the recovery audit contractor (RAC) responsible for that region. The RAC auditor was questioning claims for technical component (TC) services and seeking repayment from InCyte Pathology. It took three months and plenty of dogged determination for the InCyte team to

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