Prepare Your Lab for a Medicare RAC Audit: Essential Do’s and Don’ts to Reduce Compliance Risk and Avoid Penalties

| June 30, 2011

Pre-emptive steps to avoid fines, overpayments and even jail time


Jane Pine Wood Tom Rehwald justin clark


Jane Pine Wood, Attorney, McDonald Hopkins, LLC

Tom Rehwald, CPA, Chief Financial Officer, InCyte Pathology, PS

Justin M. Clark (Moderator), Director of Operations, THE DARK REPORT

LIVE Event July 20 – Register NOW!

Recovery Audit Contractors Program (RAC) is the new Medicare program that sends independent auditors to provider facilities, including clinical labs and pathology groups. These auditors are out to recover an estimated $24 billion a year resulting from abuse, fraud, and reimbursement problems that have plagued the system for years.

How ready is your lab is for a RAC audit? Probably not very, which leaves you vulnerable when the first letter arrives from an auditor. That’s because the Centers for Medicare and Medicaid Services (CMS) have designated four independent companies to conduct RAC audits, and they’ll have surprising powers to view your source documentation.

So what steps can you take now to prepare your lab for a RAC audit? What are your rights during an audit? And how can you effectively challenge and appeal the results of a RAC audit?

Get answers to these questions and more when you register to attend the latest Dark Report and audio conference on Wednesday, July 20, 2011. Listen as two experts help you prepare your lab for an RAC audit-and how to minimize its impact.

CMS admits that most overpayments are caused by errors and omissions rather than fraud or abuse-many the result of incorrect coding or insufficient documentation. Still, it’s important to take steps now to fully understand the impact of a RAC audit, and what you can do to ensure that proper procedures are in place to reduce risk and limit your lab’s exposure.

In 90 minutes, you’ll get advice on surviving a RAC audit from the following two experts:

First, Jane Pine Wood, a health-law attorney who specializes in regulatory and compliance issues, provides critical details about the RAC audit program: what it is, how audits are performed, what areas are at risk of being audited, and more. She’ll walk you through the process, starting the moment your lab is notified it’s about to be audited. Using case-study examples, Ms. Wood will explain the procedures your lab should follow when responding to a RAC audit.

Our second speaker, Tom Rehwald, CFO at InCyte Pathology LLC, will share what happened when a RAC audit was conducted at his lab. He’ll provide the practical insights and lessons-learned that come from taking part in an actual audit. Find out how you can stay one step ahead of the auditors. Get a better understanding of the process, including the potential pitfalls you’ll need to watch out for when responding to the results of your audit.

In sports, they say the best defense is a good offense and that definitely applies when it comes to RAC audits. Taking steps now to identify and resolve potential problems before you’re audited can substantially reduce your risk of the auditors finding anything wrong.

Register today
 and get the best, most up-to-date information on how to prepare your lab for a RAC audit. Find out how to make risk assessment of your lab’s coding, billing and collections processes an ongoing part of your compliance activities. And how improving them can help you avoid future problems.

Finally, the results of an audit aren’t set in stone so don’t be afraid to challenge them, say our experts. One Florida lab appealed overpayments found during their RAC audit and was able to overturn almost 25% of them. In this session, you’ll find out how to decide whether an appeal makes sense, and if so, what steps your lab can take to contest the results of an audit.

This is a terrific opportunity for you and your management team to come up to speed on preparing for a RAC audit. Find out how to resolve noncompliance and overpayment issues before you’re hit with an audit.

And don’t forget: You can have everyone on your lab team participate with you. For just one registration, you can all listen, learn, and get personalized answers to questions about your lab’s unique needs. Register now to guarantee your participation.


 Wednesday, July 20, 2011

TIME: 1 p.m. EDT; 12 p.m. CDT; 11 a.m. MDT; 10 a.m. PDT

PLACE: Your telephone or speakerphone

COST: $195 per dial-in site (unlimited attendance per site) through 7/8/11; $245 thereafter

TO REGISTER NOW: Click here or call 1-800-560-6363 toll-free

For one low price—just $195 (through 7/8/11; $245 thereafter)—you and your entire team can take part in this fast-paced, insightful audio conference. Best of all, you’ll be able to connect personally with our speakers when we open up the phone lines for live Q&A.

Here’s just some of what you’ll learn during this in-depth 90-minute audio conference:


o The difference between a redetermination letter and reconsideration request, and what could happen if you mix up the two.

o The do’s and don’ts of crafting a redetermination letter to correct possible errors in your audit.

o Key steps for meeting compliance recommendations.

o The documentation that best supports the claims you submit to Medicare.

o How to prepare for an audit if you use a third-party billing service.

o How your lab can use the RAC experience to better educate staff and avoid future compliance and overpayment issues.



o The parallel strategies for attacking a RAC audit, including political action, that your lab should consider implementing

…and much more!

How to Register Now:

1. Online
2. Call toll free: 800-560-6363.

Your audio conference registration includes:

  • A site license to attend the conference (invite as many people as you can fit around your speakerphone at no extra charge)
  • A downloadable PowerPoint presentations from our speaker
  • A full transcript emailed to you soon after the conference
  • The opportunity to connect directly with the speaker during the audience Q&A session

Register Now!  Or for more information, call us toll-free at 800-560-6363

Distinguished Faculty: 

Jane Pine Wood is a member of McDonald Hopkins, LLC which specializes in health law, including regulatory, compliance, and contractual matters, as well as Medicaid and Medicare reimbursement issues. Ms. Wood represents physicians, hospitals, clinical and anatomic laboratories, imaging centers, home health agencies, mental health providers, clinics, independent practice associations and integrated delivery systems in corporate, regulatory, reimbursement, contractual and other areas. She received her J.D. degree in 1987 from Vanderbilt University School of Law and is admitted to practice in Massachusetts, Ohio and Tennessee.

Tom Rehwald, CPA
, has been Chief Financial Officer for InCyte Pathology, PS since 2007. He has been involved in healthcare finance and administration for more than 26 years, with experience that runs the full spectrum of a healthcare systems continuum of care. Prior to his current position, he was the CFO at Spokane Ear, Nose, & Throat Clinic and was CFO at Pathology Associates Medical Laboratories. He also held several positions at Providence Health Care/Sacred Heart Medical Center, including Director of Patient Accounts. He graduated Summa Cum Laude from San Diego State University with a Bachelor of Science degree in business administration with an emphasis in accounting.

ACCENT® Continuing Education Credit
The American Association of Clinical Chemistry (AACC) designates this program for a maximum of 1.5 ACCENT® credit hours towards the AACC Clinical Chemist’s Recognition Award. AACC is an approved provider of continuing education for clinical laboratory scientists in the states of California, Florida, Louisiana, Montana, Nevada, North Dakota, Rhode Island, and West Virginia.


Category: Pathology News

Comments are closed.