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If you’re a healthcare provider and providing health care services to recipients in Los Angeles, or the surrounding areas, then you probably have experienced being audited by a RAC – Recovery Audit Contractor. With new health care reform, RAC’s have been extensively auditing claims under Medicare Parts A, B, C, and D in every state since January 2011. Health care reforms have expanded the RAC program to Medicare. Each state is legally required to contract with a RAC no later than December 2010. As a result, Medicare audits are now a part of daily life for healthcare providers.
At the healthcare dedicated law firm of Raiser & Kenniff, PC, we defend California providers in the RAC audit process. We encourage you to contact us to learn how our experienced Los Angeles Medicare audit lawyers can help you respond to a RAC audit, or appeal the results of an audit.
All medical providers in LA should be prepared for the possibility of a RAC audit of their billing/medical records. Some examples of healthcare providers that we can help include, but are not limited to:
-Hospitals / Home Health Systems
-Hospice and HHA providers
-SNF’s – skilled nursing facilities
-Radiology providers and IDTF’s
-Ambulatory Surgery Centers
-Physicians, and Physician Groups
Irrespective of the type of medical provider – you are vulnerable to being audited by a RAC. In California – that’s HealthDataInsight, Inc., a private company. Under the RAC program, companies who do the audit – are compensated based on a % of the money that they recover due to overpayments. Providers have to also be aware of Zone Program Integrity Contractor Audits. ZPICs are CMS contractors who look for overpayments and fraud.
Our law firm has extensive experience representing medical providers in Los Angeles, and throughout the state of California. Our attorneys are constantly looking at new changes being and new regulations in order to be prepared for anything that happens. We understand the changes made to the program by the PPACA, and have experience defending providers. If you are facing an audit, or think you may be at risk, we encourage you to contact our attorneys to help you through the process.
Our attorneys regularly help clients appeal RAC audits, ZPIC audits, other medicare audits, and all types of medical payor audits. Our goal is to limit your financial exposure, and maintain a focus on profitability so you can continue to provide high quality medical services without being inconvenienced by audits.