2018 RAC CERTIFICATE PROGRAM – SUGGESTED PRECONFERENCE READINGS
NOTE: These are suggested background reading to fill any gaps in knowledge. They are not required reading for purposes of the certificate exam, whose questions are drawn directly from the speaker presentations.
General References:
CMS’s website for all 2 MN updates: www.cms.gov
AR System’s webpage for free classes: www.arsystemsdayegusquiza.com
- The Original RAC Contractors’ Scope of Work and Contingency Fee %
https://www.fbo.gov/index?s=opportunity&mode=form&id=5c8c7d4b00249ba579d4d77d64bd0aea&tab=core&_cview=1&cck=1&au=&ck=
- CMS Chart: Provider Options – RAC Overpayment Determination
http://www.RACSummit.com/readings/ProviderOptionsChart.pdf
- CMS Final Rule on Medicaid RACs
https://www.racsummit.com/resources/CMS_Medicaid_RAC_Rule.pdf
- AHA Letter August 24, 2012 to HHS OIG re Contractor Burden
https://www.racsummit.com/resources/AHA_OIG_Letter.pdf
- PAHA Regulatory Brief on Rebilling
https://www.racsummit.com/readings/AHA Briefing on Rebilling.pdf
- MM8185 — CMS Administrator’s Ruling: Part A to Part B Rebilling of Denied Hospital Inpatient Claims
https://www.racsummit.com/readings/MM8185.pdf
- CMS 1455 — Appeal Withdrawal Form
https://www.racsummit.com/readings/Appeal Withdrawal Form.pdf
- Beebe Medical Center – “Because” Item in Medical Staff Neswsletter
https://www.racsummit.com/readings/Beebe – Because item in Med Staff Newsletter.pdf
- HCPro RAC Benchmarking Report 2013
https://www.racsummit.com/readings/HC Pro RAC Benchmarking Report 2013.pdf
- National Map of New RAC Regions
https://www.racsummit.com/readings/National Map of New RAC Regions.pdf
- Beebe Documentation Item in Medical Staff Office Update
https://www.racsummit.com/readings/Beebe_Documentation_item_in_Med_Staff_Newsletter_p6.pdf
- AHA Comments 2 Midnight Rule – Sep. 18, 2013
https://www.racsummit.com/readings/AHA Comments 2 Midnight Rule – Sep. 18, 2013.pdf
- Accretive Brief Inpatient Order before Inpatient Only Surgery
https://www.racsummit.com/readings/Accretive Brief Inpatient Order before Inpatient Only Surgery.pdf
- 2014 IPPS Final Rule for Dummies
https://www.racsummit.com/readings/2014 IPPS Final Rule for Dummies.pdf
- First Coast Service/MAC Options Q&A – Aug. 2013
https://www.racsummit.com/readings/First_Coast_Service_Options_Q_A_-_Aug._2013
- CMS FAQ on 2MN – Sep 26, 2013
https://www.racsummit.com/readings/CMS FAQ on 2MN – Sep 26, 2013.pdf
- WPS Briefing Document – 2MN Issues – Nov. 2013
https://www.racsummit.com/readings/WPS Briefing Document – 2MN Issues – Nov. 2013.pdf
- CMS Transmittal 1315 Patient Status Reviews Nov 2013
https://www.racsummit.com/readings/CMS Transmittal 1315 Patient Status Reviews Nov 2013.pdf
- CMS Inpatient Hospital Reviews – Updated June 6, 2016
http://cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medical-Review/InpatientHospitalReviews.html
- CMS MLN #SE1403 – MAC Probe & Educate
https://www.racsummit.com/readings/CMS_MLN_SE1403_-_MAC_Probe_&_Educate.pdf
- CMS FAQ on 2MN – Feb 24 Update
https://www.racsummit.com/readings/CMS FAQ on 2MN – Feb 24 update.pdf
- AHA 2014 Advocacy Brief – Program Integrity
https://www.racsummit.com/readings/AHA 2014 Advocacy Brief – Program Integrity.pdf
- Guidelines for Inpatient vs Outpatient Observation (shared by Concord Hospital)
https://www.racsummit.com/readings/Guidelines for Inpatient vs Outpatient Observation.pdf
- How to Properly Audit an Admission for Compliance with the 2 Midnight Rule (video by Ron Hirsch, MD)
https://www.youtube.com/watch?v=dB4T0xw-8XU&feature=youtu.be
- Appeal Academy Decsion Tree for 2MN Rule
https://www.racsummit.com/readings/Appeal Academy Decision Tree – Conversions at 2 Midnights.pdf
- Accretive Health Work Flow for 2MN Rule
https://www.racsummit.com/readings/Accretive Health – Work Flow for 2MN Rule.pdf
- The Health Law Partmers Appeals Brief
https://www.racsummit.com/readings/The Health Law Partners – Appeals Brief.pdf
- Recovery Audit Contractor Audits and Appeals at Three Academic Medical Centers
https://www.racsummit.com/readings/RAC Audits & Appeals at 3 Academic Med Centers.pdf
- CMS Case Studies
https://www.racsummit.com/readings/CMS_Case_Studies.pdf
- CMS Fact Sheet on 2MN Rule – July 2015
http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-07-01-2.html
- Clarity on Enrollment Rules of Medicare Managed Care
https://www.racsummit.com/readings/Clarity_Enrollment_Rules_Medicare_Mgd_Care_2016.pptx