RACs and ALJ
Kevin Matthews
Description
Collection
Title:
RACs and ALJ
Creator:
Kevin Matthews
Date:
3/19/2013
Text:
I recently read 60% of audits are producing denials. I h
Hello all,
I recently read 60% of audits are producing denials. I had said earlier on this list that when it gets to the ALJ 100% would be paid if your notes are OK. They don't have to be perfect. You just need to get to a rational informed human being. The audits produce denials for simple paperwork errors. If in the end these are all paid, after a year or more of appeals, has the government saved anything, or has it just cost them much more for the service? It seems to me we have a completely dysfunctional system.
The president said he saved Medicare $760 Billion, mainly on the backs of providers. I wonder if they think they are saving money by putting off payments? I know some will give up and take the loss, which actually hurts us all because they consider this money saved a fraud prevented, but that cannot outweigh the cost to the government for all these appeals. Everyone should be appealing all the way to the ALJ, at least those that can stay in business long enough.
A final note. I just sent in my renewal to NAAOP, a couple months late. My company is just getting by and the $1000 was not easy to part with, but I know they are fighting to preserve our profession. Please join us in the fight!
Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
<Email Address Redacted>
Hello all,
I recently read 60% of audits are producing denials. I had said earlier on this list that when it gets to the ALJ 100% would be paid if your notes are OK. They don't have to be perfect. You just need to get to a rational informed human being. The audits produce denials for simple paperwork errors. If in the end these are all paid, after a year or more of appeals, has the government saved anything, or has it just cost them much more for the service? It seems to me we have a completely dysfunctional system.
The president said he saved Medicare $760 Billion, mainly on the backs of providers. I wonder if they think they are saving money by putting off payments? I know some will give up and take the loss, which actually hurts us all because they consider this money saved a fraud prevented, but that cannot outweigh the cost to the government for all these appeals. Everyone should be appealing all the way to the ALJ, at least those that can stay in business long enough.
A final note. I just sent in my renewal to NAAOP, a couple months late. My company is just getting by and the $1000 was not easy to part with, but I know they are fighting to preserve our profession. Please join us in the fight!
Kevin C. Matthews, CO/LO
Advanced Orthopedic Designs
12315 Judson Rd. #206
San Antonio, Texas 78233
210-657-8100
210-657-8105 fax
www.AdvancedOrthopedicDesigns.com
<Email Address Redacted>
Citation
Kevin Matthews, “RACs and ALJ,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 7, 2024, https://library.drfop.org/items/show/234880.
