Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs

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9781601467164: Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs
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Cutting-edge strategies to prepare and respond to Medicare audits

Know what to expect during a long-term care Medicare audit

The book Medicare Audits in Long-Term Care: A Guide to MACs, RACs, and ZPICs describes the different types of Medicare audits that nursing homes face and helps you take a proactive approach to audit preparedness. You also receive detailed descriptions of what you can expect during the different types of Medicare audits, how to conduct an internal audit, specific ways to prepare for an audit, and what to do once you have been audited.

This resource helps you:

- Gain a comprehensive understanding of the agencies responsible for conducting Medicare audits
- Grasp the processes and steps an auditor takes so you know what to expect and can be prepared
- Conduct an internal audit with the internal audit checklists provided
- Learn specific risk areas and vulnerabilities that may be present in your facility
- Understand where to focus internal efforts and controls as is relates to compliance

Table of Contents

Chapter 1: Medicare Oversight of Skilled Nursing Facilities
Chapter 2: Medical Review Audits
Chapter 3: Recovery Audit Contractor Audits
Chapter 4: Benefit Integrity Audits
Chapter 5: Comprehensive Error Rate Testing Program
Chapter 6: Department of Health and Human Services / Office of Inspector General
Chapter 7: Medicare Advantage Plans
Chapter 8: Audit Case Examples
Chapter 9: Preparing your Facility for an Audit
Chapter 10: Post Audit Processes
Tools & Checklists

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About the Author:

Wayne van Halem, AHFI, CFE, President, The van Halem Group, has worked in various leadership roles at multiple Medicare contractors. Throughout his tenure, he served as a Fraud Analyst, Medicare Fraud Information Specialist, Investigator, Supervisor, Appeals Manager, and Consultant. He is an Accredited Healthcare Fraud Investigator and a Certified Fraud Examiner.

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HCPro; Wayne van Halem AHFI CFE President
Published by HCPro (2010)
ISBN 10: 1601467168 ISBN 13: 9781601467164
Used Softcover First Edition Quantity Available: 1
(Minden, NV, U.S.A.)

Book Description HCPro, 2010. Condition: Good. A+ Customer service! Satisfaction Guaranteed! Book is in Used-Good condition. Pages and cover are clean and intact. Used items may not include supplementary materials such as CDs or access codes. May show signs of minor shelf wear and contain limited notes and highlighting. Seller Inventory # 1601467168-2-4

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