Academy of Chiropractic Personal Injury & Primary Spine Care Program
Quickie Consult 251
"RAC and Restrospective Audits"
RACs are "recovery audit contractors" and used by Medicare to get back money paid to you and then some. All third parties (insurance carriers) use RACs in some form because as I have said previously, you are big businesses to them because you are their easiest paydays. Simply send a letter, get your charts and based upon errors you've made, they threaten you and you write a check. Simple...but dangerous.
According to Kirschenbaum and Weinrib, 2 lawyers who wrote in the Dynamic Chiropractic, July 15, 2011, page 1, getting audited is problematic, but writing the check can be worse because "any return of funds will be treated as an admission of fault." In addition, the article goes on to say that often auditors make errors and you should fight...IF...you didn't make an error.
I haven't written about this in a quite some time. However, that doesn't mean it hasn't been the focus of many conversations with doctors nationally. This is an increasing problem with the individual carriers seeing the successful outcomes in recovery for the government. As previously reported, the Federal Government has increased the RACs six-fold over the last 12 months and the private carriers have joined the bandwagon, going after the easiest prey in the business world...you. As a note, if you are one of those "really smart people" who still feel you know better and continue to use "travel cards," I applaud you for your willingness to be part of the economic recovery of corporate America. Your checks that you WILL be writing will go toward eradicating the national debt for Medicare audits and increasing the profit margins and subsequent stock values of the private insurers. Expect a Christmas card in thanks!!!! (Sarcasm intended at a much higher level than this space will allow.)
I have previously and continue to urge each of you to hire Dr. Michael Schonfeld, 516-695-7732, email@example.com, to have a voluntary internal audit. He is one of the best and the least expensive solution to identifying problems that can be fixed BEFORE you have an issue to PREVENT the audit. For all of the rest of the really smart people who do not have an independent compliance firm/expert working with you to ensure you are doing it correctly, see the sarcastic comment above; it applies here as well.
I have seen too much, spoken to too many and read too much to think I know better as a practitioner. As a practitioner, I live in the "healing world" and need to recognize compliance is my goal, not my focus. I need others who do that to have focus on MY practice.