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Tag : auditing

Loophole allows low volume Medicare providers exemption from auditing

In May 2016, the Centers for Medicare & Medicaid Services announced new additional documentation request (ADR) limitsfor Medicare Recovery Audit Contractors (RACs) that review claims to identify and recover improper payments. The new policy reduced the annual ADR limit so auditors can review just 0.5 percent of a provider’s total number of paid Medicare claims. However, after three 45-day billing periods, CMS would then review provider billing accuracy rates and adjust each provider’s ADR limit higher or lower based on their […]