At the American Health Lawyers Association's Institute on Medicare and Medicaid Payment Issues conference, CMS said recovery audit contractors will be encouraged to extrapolate overpayments, according to a Lexology report.
Although RACs have always had the power to extrapolate overpayments, they will be actively encouraged to do so within the coming year. RACs extrapolate overpayments made to a facility by projecting a global error rate to a universe of claims using a sampling of a specific set of statistics. Extrapolation will likely be focused on small dollar claims identified in the Comprehensive Error Rate Testing program, which may require providers to reevaluate their defense strategies, according to the report.
CMS made other predictions for the coming year at the conference, including an increase in RAC involvement in appeals, especially at the administrative law judge level. CMS also described an effort to use the term "recovery auditor" instead of RAC.
Read the Lexology report on recovery audit contractors.
Read more coverage on RACs:
- Physicians Doing Work of RACs, Study Seems to Indicate
- CMS Clarifies Remittance Advice
- RACs' Semi-Automated Review Explained
Although RACs have always had the power to extrapolate overpayments, they will be actively encouraged to do so within the coming year. RACs extrapolate overpayments made to a facility by projecting a global error rate to a universe of claims using a sampling of a specific set of statistics. Extrapolation will likely be focused on small dollar claims identified in the Comprehensive Error Rate Testing program, which may require providers to reevaluate their defense strategies, according to the report.
CMS made other predictions for the coming year at the conference, including an increase in RAC involvement in appeals, especially at the administrative law judge level. CMS also described an effort to use the term "recovery auditor" instead of RAC.
Read the Lexology report on recovery audit contractors.
Read more coverage on RACs:
- Physicians Doing Work of RACs, Study Seems to Indicate
- CMS Clarifies Remittance Advice
- RACs' Semi-Automated Review Explained