The Federal Appeals Process for Recovery Audit Contractors’ (RACs) Determinations of Improper Payment: What Every Hospital Must Know!

Thursday, March 25, 2010

1:00pm - 2:00pm
WEBINAR

$249 MHA Member Rate
$349 Non-Member Rate

This Webinar presents a description of the federal administrative appeals process applicable when a Medicare contractor denies a claim for reimbursement. The presentation includes a description of the process used by Medicare contractors, (FIs, MACs, and RACs) to make determinations of improper payments, including their procedures for making additional document requests (“ADR”s). The rights of hospitals in this process will be discussed. The procedures for appealing RAC determinations will be explained and practice tips will be offered on avoiding pitfalls in the process, preventing recoupment of alleged overpayments before the appeal is decided; and on persuasively addressing “medical necessity” issues.

WEBINAR OVERVIEW

Program Topics:

• Types of post-payment reviews and audits Medicare Contractors perform
• A description of the procedures used by Medicare contractors to request additional
   documents from providers
• Four levels of administrative appeal available to providers aggrieved by claims denials,
   with a discussion of the features unique to each level
• Essential elements of a request for administrative appeal
• Limitations on Medicare’s ability to recoup funds from providers during the
   administrative appeals process

Objectives:

At the completion of this program, the participants will be able to:
1. Identify the essential elements of a request for appeal
2. Discuss the four levels of administrative appeal and certain pitfalls that exist in the
process
3. List the steps to take to prevent recoupment of the disputed funds during the first
two levels of appeal

REGISTER

Credit Card - FAX 781.272.0466
Check Payable to MHA - MAIL
MHA Education Department
5 New England Executive Park
Burlington, MA 01803-5096

**Please remember the registration fee includes one connection per registered facility. An unlimited number of staff can gather in one room to “attend” the webinar. Additional line connections will be billed accordingly.