Medical billing may start to compromise patient medical records in the near future. Medicare has reason to believe that there are Medicare Affiliated Contractors (MACs) that have failed to spot overpayments to providers. This belief has led to a medical billing investigation in the country. The Recovery Audit Contractors (RACs) will do a medical billing audit in three US states.

New York, California, and Florida are the first states to receive this in-depth medical billing audit. There will be a three year investigation with these states to determine if a substantial amount of money was overpaid to their providers. If the results show there was too much paid, this medical billing investigation may lead to the entire United States.

The Recovery Audit Contractors will use a three tiered system in claims review. Medicare Part A claims will be reviewed first. These are the diagnosis related group claims (DRG). During this tier, the RACs will request medical records that support the medical billings submitted.

The second tier is when the RAC examines claims in the data mining systems to see if there are any overpayments. The last tier in the medical billing audit is the examination of Medicare Part B services. The RAC will ask for medical records for these types of services as well.

This investigation of medical billing practices goes to show that even if years pass by, overpayments are never safe with your practice. The Centers for Medicare & Medicaid Services may take three years to find out you have been overpaid, but they will get their money back. Don’t spend money you know you shouldn’t have received. If you notice an error in payment, let your Medicare Affiliated Contractor know about it. There is nothing worse in medical billing that an error.