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2016 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 http://www.racsummit.com/resources/CMS_Medicaid_RAC_Rule.pdf AHA Letter August 24, 2012 to HHS OIG re Contractor Burden http://www.racsummit.com/resources/AHA_OIG_Letter.pdf AHA Regulatory Brief on Rebilling http://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 http://www.racsummit.com/readings/MM8185.pdf CMS 1455 -- Appeal Withdrawal Form http://www.racsummit.com/readings/Appeal Withdrawal Form.pdf AHIMA Publication Achieving Compliant Queries http://www.racsummit.com/readings/AHIMA Publication Achieving Compliant Queries.pdf Beebe Medical Center "Because" Flier http://www.racsummit.com/readings/Because - Flier at Beebe Medical Center.pdf Beebe Medical Center - "Because" Item in Medical Staff Neswsletter http://www.racsummit.com/readings/Beebe - Because item in Med Staff Newsletter.pdf HCPro RAC Benchmarking Report 2013 http://www.racsummit.com/readings/HC Pro RAC Benchmarking Report 2013.pdf National Map of New RAC Regions http://www.racsummit.com/readings/National Map of New RAC Regions.pdf Beebe Documentation Item in Medical Staff Office Update http://www.racsummit.com/readings/Beebe_Documentation_item_in_Med_Staff_Newsletter_p6.pdf AHA Comments 2 Midnight Rule - Sep. 18, 2013 http://www.racsummit.com/readings/AHA Comments 2 Midnight Rule - Sep. 18, 2013.pdf Accretive Brief Inpatient Order before Inpatient Only Surgery http://www.racsummit.com/readings/Accretive Brief Inpatient Order before Inpatient Only Surgery.pdf 2014 IPPS Final Rule for Dummies http://www.racsummit.com/readings/2014 IPPS Final Rule for Dummies.pdf First Coast Service/MAC Options Q&A - Aug. 2013 http://www.racsummit.com/readings/First_Coast_Service_Options_Q_A_-_Aug._2013 CMS FAQ on 2MN - Sep 26, 2013 http://www.racsummit.com/readings/CMS FAQ on 2MN - Sep 26, 2013.pdf WPS Briefing Document - 2MN Issues - Nov. 2013 http://www.racsummit.com/readings/WPS Briefing Document - 2MN Issues - Nov. 2013.pdf CMS Transmittal 1315 Patient Status Reviews Nov 2013 http://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 http://www.racsummit.com/readings/CMS_MLN_SE1403_-_MAC_Probe_&_Educate.pdf CMS FAQ on 2MN - Feb 24 Update http://www.racsummit.com/readings/CMS FAQ on 2MN - Feb 24 update.pdf AHA 2014 Advocacy Brief - Program Integrity http://www.racsummit.com/readings/AHA 2014 Advocacy Brief - Program Integrity.pdf Guidelines for Inpatient vs Outpatient Observation (shared by Concord Hospital) http://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 http://www.racsummit.com/readings/Appeal Academy Decision Tree - Conversions at 2 Midnights.pdf Accretive Health Work Flow for 2MN Rule http://www.racsummit.com/readings/Accretive Health - Work Flow for 2MN Rule.pdf The Health Law Partmers Appeals Brief http://www.racsummit.com/readings/The Health Law Partners - Appeals Brief.pdf Recovery Audit Contractor Audits and Appeals at Three Academic Medical Centers http://www.racsummit.com/readings/RAC Audits & Appeals at 3 Academic Med Centers.pdf Warning: The Medicare Auditors are Back Revisiting the Two Midnight Rule http://www.racsummit.com/readings/PA Blog on 2 MN Cases.pdf CMS Case Studies http://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 AHA RAC Trac Report - 4th Qtr 2015 http://www.aha.org/content/16/160628ractracwebinar.pdf Clarity on Enrollment Rules of Medicare Managed Care http://www.racsummit.com/readings/Clarity_Enrollment_Rules_Medicare_Mgd_Care_2016.pptx

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