Medical Industry Updates
ForwardHealth interChange is the new system which replaces the current Medicaid Management Information System (MMIS) which has been in place since 1977. ForwardHealth interChange handles claims, prior authorization and other services for many of the Wisconsin state healthcare programs within a single system.
ForwardHealth Contact Information
ForwardHealth interChange Implementation Dates
ForwardHealth Terms & Definitions
Programs under ForwardHealth:
Wisconsin Well Woman Medicaid
Wisconsin Chronic Disease Program
Wisconsin Well Woman Program
BadgerCare Plus and Medicaid managed care programs:
BadgerCare Plus HMOs
Medicaid SSI HMOs
Wisconsin Partnership Program
Children Come First
Program of All-Inclusive Care for the Elderly
ForwardHealth InterChange Web sites:
ForwardHealth implementation information:
ForwardHealth InterChange portal:
The Medicare Recovery Audit Contractor Program in Wisconsin.
The RAC Recovery Audit Contractor Program was developed as a demonstration to identify improper Medicare payments made to health care providers that were not detected through existing error detection and prevention efforts. The RAC programs mission: To reduce Medicare improper payments through the efficient detection and collection of overpayments, the identification of underpayments, and the implementation of actions that will prevent future improper payments.
Preparing for RAC in Wisconsin
Recovery Audit Contractors UPDATE:
The Centers for Medicare & Medicaid Services (CMS) recently announced a revision to the roll-out of the permanent Recovery Audit Contractors (RAC) program implementation timeline. Under this new roll-out, it appears Wisconsin will now not see RAC audits until August 2009 at the earliest. As of now, CMS still intends to announce the permanent RACs by October 1, 2008.
The American Hospital Association will have a series of educational sessions for its member hospitals over the next several months. The access more information and/or participate in these audio-conferences, log onto: www.aha.org/aha/issues/RAC/educational.html
WHA is offering a two-part audio conference series in October focused on the issues surrounding the RAC initiative. Part one will be offered October 1, and will touch on the history of the initial three-state findings. Significant time and specific emphasis will be placed on practical strategies for multi-department integration, defensive audits focusing on known issues, and ideas for ongoing education and prevention.
Part two will be offered October 23 and will walk participants through the vulnerabilities identified when a health care facility does not have a good understanding of what observation is. Exposure areas will be discussed and enhanced tools will be provided to reduce lost revenue. One-day stay thresholds and integrated approaches will also be included. On-line registration and additional information about these sessions is posted at www.wha.org.
RAC Attack Audio Conferences Focuses on Utilizing Observation Correctly
As part of its continuing efforts to keep members informed and educated about preparing for the Recovery Audit Contractors (RAC), WHA is offering the audio conference "RAC Attack: Utilizing Observation Correctly to Prevent Exposure with One-Day Stays and Short Stays," on October 23.
This audio conference will walk participants through the vulnerabilities identified when a health care facility does not have a good understanding of observation. Exposure areas will be discussed and enhanced tools will be provided to reduce lost revenue. One-day stay thresholds and integrated approaches will also be included.