Medicare auditors becoming more active, denying more claims, survey shows

Mcknights.com: McKnight’s Staff August 29, 2012
Requests for medical records by Medicare’s fraud-detecting recovery audit contractors (RACs) jumped sharply from the first- to the second-quarter of fiscal year 2012, a new survey reveals.

RACs, which are contracted by the Centers for Medicare & Medicaid Services to detect healthcare fraud and recover Medicare and Medicaid overpayments from providers, requested 546,000 medical records in the second quarter of 2012. That’s a 22% increase over the 448,000 the previous quarter, according to a survey conducted by the American Hospital Association.

Providers also experienced in increase in the denial of claims, both automated and complex over that same time, AHA survey results showed. Read more