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picture1_Ppt Consulting 66561 | Rac Project Familiarization Presentation Fy19


 219x       Filetype PPTX       File size 0.38 MB       Source: dhcf.dc.gov


File: Ppt Consulting 66561 | Rac Project Familiarization Presentation Fy19
learning process content introduction background authoritative sources objective scope approach appeals and legal process customer service reference materials introduction identified entities for the rac project are the department of health ...

icon picture PPTX Filetype Power Point PPTX | Posted on 27 Aug 2022 | 3 years ago
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       LEARNING PROCESS (CONTENT)
      •
        Introduction
      •
        Background-Authoritative Sources
      •
        Objective
      •
        Scope
      •
        Approach
      •
        Appeals and Legal Process
      •
        Customer Service
      •
        Reference Materials
           INTRODUCTION
           Identified entities for the RAC project are:
           The Department of Health Care 
              Finance(DHCF) 
           Prempeh Consulting, CPAs (PCC), RAC 
           PCC, the Medicaid RAC, with the consent of DHCF, hereby, presents the Medicaid Providers’ Outreach 
           Familiarization Program to, accordingly, inform health providers about the modalities of the RAC process.
     BACKGROUND- Authoritative Sources
     Section 1902(a)(42)(B)(i) of the Social Security Act
     District of Columbia Municipal Regulations 
      Chapter 93 of Title 29 Medicaid
     42 CFR Part 455, Subpart F Medicaid Program
     42 CFR Part 456, Subpart B
     Section 6411 of the Patient Protection and 
      Affordable Care Act
     OBJECTIVE
     To conduct desktop and/or onsite reviews 
     of Providers’ claims data for Medicaid-
     covered items and services, and to identify 
     improper payments (overpayments and 
     underpayments).
     SCOPE
     RAC project covers Providers’ District 
      Medicaid Management Information System 
      (MMIS) claims data and, potentially, medical 
      records.
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...Learning process content introduction background authoritative sources objective scope approach appeals and legal customer service reference materials identified entities for the rac project are department of health care finance dhcf prempeh consulting cpas pcc medicaid with consent hereby presents providers outreach familiarization program to accordingly inform about modalities section a b i social security act district columbia municipal regulations chapter title cfr part subpart f patient protection affordable conduct desktop or onsite reviews claims data covered items services identify improper payments overpayments underpayments covers management information system mmis potentially medical records...

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