What’s the Missing Ingredient in Medicare Audits?

Monitor Mondays

“Good enough for government work,” was once the saying among cynical factory workers. And yet today in healthcare, precision in Medicare statistical analysis really matters. If overpayments are found, then the extrapolation recoupment number will go up; if underpayments are found, the extrapolation will go down.

Listen and learn during the next live edition of Monitor Mondays when RACmonitor investigative attorney Edward M. Roche will report that his team routinely finds Medicare auditors handing in extrapolations that can be plus or minus 10, 15, 20, 30 percent – or even worse.

“That is somewhere between 25 and 85 percent,” wrote Roche recently in RACmonitor. “But that seems to be good enough for government work.”

Precision in Medicare auditing is a prerequisite. But, sadly—as you’ll learn from Roche—that’s not always the case.

Other segments will include these instantly recognizable broadcast segments:

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.
  
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.
• Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.