RAC on the Go

“A Medicare auditor tasked with reviewing past claims for physician and hospital services in 15 states will start scrutinizing the billing of office visits, claims that previously had been off-limits to recovery audit contractors.”  This is how the American Medical News article starts off.   It says it all.  The RAC or Recovery Audit Contractors are like hounds that have been let loose by the government.   And this will not be pretty.  As I have written about before, our coding system is a joke.  That being said, we have to play the documentation game as it was given to us.  Now the government, who set the rules, are after the “upcoders” and “cloners”.  Godspeed to you docs out there.  My prayers are with you.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “RAC on the Go

  1. big picture doc
    October 4, 2012 at 5:41 pm

    And how stupid are the sheep that allowed the AMA and big insurance to do this. Stupidity and greed. A bad combination.

  2. Craig
    October 3, 2012 at 12:24 pm

    I am a busy internist, but see only 20-24 patients a day, while I know two others in my community who see 40+ a day. Now Humama, Untited health Care, and others are requesting my notes from 1/1/2011 forwards, looking for fraud. I have a simple answer for them. Show me the fraud. If they say, “In this complex patient where you addressed many conditions, and reviewed huge amounts of data,but you billed a 99214,and you didn’t have a social history in the note.”, then I will repay the difference in level of care, that the insurance company thinks it is owed. Then I will call the patient, and explain that their insurance company and I cannot work out an agreement on how to care for them. I will tell the patient I can no longer be their doctor. Yes I will do this. Every time. Why? You have no power with insurance companies. I will tell the patient that once they switch insurance companies, then, and only then, can they come back. I live in a physician shortage area. I fear in the big cities this won’t work because doctors have proven they cannot work together.

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