PROFESSIONAL
RESOURCES
To join by phone:
(800) 522-9452
Medicare’s Recovery Audit Contractor (RAC) Program
CMS is often asked about the phase-in strategy for RAC reviews. CMS has implemented a phase-in strategy by review type. CMS' phase-in strategy can be found in the downloads section on the recent updates page located here: http://www.cms.hhs.gov/RAC/03_RecentUpdates.asp CMS has not put a phase-in strategy in place by provider type. All provider types are available for RAC review once provider outreach has occurred in the state. Any reviews completed by the RAC must have been first approved by CMS and posted to the RAC websites.
CMS is often asked about other claim types that may be affected by a full inpatient denial and if the RACs will deny other claim types associated with the inpatient stay, such as physician evaluation and management services. At this time the RAC will not automatically deny claims that are associated with a full inpatient denial. However, these claims may be reviewed individually and there may be a need to fully/partially adjust the claim based on the documentation submitted.
For additional information and resources concerning the RAC Program, please visit Connolly Consulting Associates RAC webpage here: http://www.connollyhealthcare.com/RAC/Pages/cms_RAC_Program.aspx and the RAC page on the CMS website here: http://www.cms.hhs.gov/ra
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Now Available – Aspirin Therapy Materials!
Did you know Aspirin Therapy reduces the risk for CHD events by 28%? The U.S. Preventive Services Task Force (USPSTF) strongly recommends that clinicians discuss aspirin therapy with their adult patients.
Now available are materials developed by The Oklahoma State Medical Association’s Physicians’ Campaign for a Healthier Oklahoma and the Oklahoma State Department of Health.
Aspirin Therapy posters and bookmarks for patients and a physician brochure are available free of charge.
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Your Health
The physicians of the Oklahoma State Medical Association (OSMA) are concerned about the health of our states residents. Data compiled by the Oklahoma State Department of Health show that Oklahomans overall health is worse than the rest of the nation. In response the OSMA has developed the Physicians Campaign for a Healthier Oklahoma (PCHO) to make a difference in the health and quality of life of all Oklahomans.
Your Life
Did you know:
Oklahomans rank higher than much of the nation in deaths related to heart disease, stroke, cancer, chronic obstructive pulmonary disease (emphysema), cancer and injuries?
Oklahomans who smoke, consume more cigarettes than much of the nation?
One in five Oklahomans is seriously overweight. Individuals who are overweight significantly increase their risk of developing diabetes?
Oklahoma high school students that use tobacco in some form are at risk for a lifelong nicotine addiction and its associated health problems?
Your Choice
The following questions are taken from a survey developed by the Physicians Campaign for a Healthier Oklahoma to determine an individuals health behaviors and lifestyle choices:
Do you use tobacco in any form?
In your opinion are you overweight?
Are you reluctant to exercise regularly?
In your opinion are you under a lot of stress?
"Yes" answers to the above questions may indicate dangerous health behaviors. Consult your physician to discuss your answers to these questions and ways to make a lasting impact on your lifestyle choices for a healthy future.
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