Is your Mac slowing down? Do you spend more and more time waiting for applications to do what you want? If so, there is a very good chance that you have high memory usage and need a Mac RAM upgrade.

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What is RAM?

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RAM stands for Random Access Memory. This memory is temporary and used by the CPU to hold information that processes are actively using on your system. Your Mac slows down when it experiences high memory usage, in other words, when the running applications demand more RAM than your Mac is able to provide. The more RAM available, the better your Mac is able to execute on the tasks that are being thrown at it.

The obvious solution would be to increase Mac RAM, but before we show you how to do that, let’s make sure that your lack of RAM is actually the cause of your Mac slowdown.

Note: Not all devices are able to upgrade RAM, like the MacBook Air and the 2014 edition of the Mac Mini.

How to manually check Mac RAM

Checking your RAM is dependent on the version of macOS that you have installed. You should check your Mac RAM after you have been using your Mac for a bit of time. When you are in the middle of normal daily tasks, follow these steps.

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• Open Spotlight Search.
• Type in ”Activity Monitor”.
• Click on the “Memory” tab on the top of the window.

Memory Pressure is the graph you need to study.

If there is mostly green, your system RAM is currently fine. If there is a lot of yellow, the jury is still out. If there is a lot of red, your memory is under strain and your Mac has a high memory usage.

Older OS X versions like Leopard and Lion

For older versions of Mac OS X the steps are the same but the System Memory tab looks a bit different. You’ll want to look for Free and Page Outs.

Free – This is how much free RAM your Mac currently has. If you’ve got a bunch of applications open and there is still a good number of free RAM, then your Mac may have enough memory.

Page Outs – This number tells you how often your Mac has run out of RAM and needed to use the slower hard disk instead. A high number here is very bad and a sure sign that your Mac doesn’t have enough RAM.

Use a Mac memory analysis tool

Another alternative, which will work easily on all versions of Mac OS X, is to use a 3rd party tool to check your RAM usage. I highly recommend CleanMyMac X, which will not only clean and speed up your Mac, it also has a RAM monitoring tool called Menu App.

When you install CleanMyMac X, click on the Maintenance tab in the sidebar.

Here you can free up RAM with just one button. When to use this tool? When your Mac or a particular app hangs up, this feature will temporarily flush memory, helping your Mac to unfreeze.

CleanMyMac X has a free version you can download. So try it out and get to the bottom of your high memory usage problem.

Note: With all above solutions we recommend checking the results on a regular basis until you are certain that your Mac needs a RAM upgrade.

How to upgrade your Mac RAM

If you have reached the conclusion that you need more memory, we are going to show you exactly how to increase your Mac RAM. Don’t worry if you’ve never done it before, as this guide will help you every step of the way.

The first steps are to gain knowledge about your system. This will help ensure that the RAM that you get will be compatible with your system.

Step 1 – What kind of Mac do you have?

Whether you have an iMac, a MacBook Pro, or any other kind of Mac, there is a lot more information to be found out in order to identify your exact system. To get these details, follow these easy steps:

• Click on the Apple icon.
• Select “About this Mac.”
• View your system information.

Step 2 – Do I have space for more RAM in my Mac?

This may not be what you want to hear but it’s possible that you can’t add more RAM to your Mac, even if you wanted to. Let’s look under the hood and see what your RAM situation is like.

• Following on from Step 1, click on “More Info” on the “About this Mac” window.
• The complicated looking System Profiler will launch. Click on “Memory” in the left column.

On the right you will see exact details of your RAM modules or sticks. The “banks” are the slots that the RAM is inserted into. If you have an empty bank or two, you’re in luck, upgrading your Mac RAM just got that much easier.

Step 3 – Check how much RAM your Mac can take

Now let’s really make sure you can upgrade your RAM. Head over to Technical Specifications on Apple Support, find your exact Mac model. Once you find your Mac, click it to reveal a ton of information. What you’re looking for is the information, which will tell you how much RAM your system can work with. Compare it to your Mac’s current RAM (from Step 2) and now you know if you can upgrade your RAM or if you are stuck with what you have.

If you can’t upgrade your Mac RAM, download CleanMyMac X and use all of the cleaning tools to boost your Mac performance. You should also take a look at the performance improving solutions found in How To Fix Mac Running Slow.

Step 4 – Purchasing RAM for your Mac

In Step 3 you navigated to your Mac model and discovered what memory your system could potentially add. Now it's only a matter of choosing your new RAM and we recommend to start with this source. If you're located outside of the US, Google will probably tell you which stores sell RAM nearby.

Step 5 – Installing RAM into your Mac

Adding your new RAM into your Mac is not as hard as it sounds. This is definitely an upgrade that you can perform yourself, as long as you have a screwdriver on hand. The only tricky thing is to know exactly where the RAM is, and that it varies between types of Macs.

Below are handy tutorials to install new memory on your specific type of Mac.

How to upgrade RAM on an iMac

• Shut down your iMac and unplug everything.
• Place iMac face down, ensuring the screen is protected from anything that could scratch it.
• Unscrew, counterclockwise, the RAM panel in the centre until it pops out.
• Expose ribbon tab over RAM and pull on it to release RAM module.
• Use your fingers to remove the RAM entirely.
• Line up the new RAM with the now empty slot and push it in until it clicks into place.
• Screw the RAM panel cover back on.
• Re-connect everything, turn your iMac back on and go to About This Mac to confirm new RAM installed.

How to upgrade RAM on a MacBook Pro

• Turn your MacBook off.
• Turn your MacBook upside down and pop the latch on the back to remove the plate.
• Use tiny Phillips head screwdriver to unscrew the larger back plate.
• Note - one screw will be a lot smaller than the others. Remember where it goes.
• Touch metal to ground yourself before touching the RAM.
• The RAM is to the left or right of centre. Pull apart the latches on each side of it and the RAM will pop up.
• Slide the RAM out.
• Slide the new RAM into the slot and push it down till it clicks into place.
• Put the large backplate back on and screw it into place.
• Screw the smaller backplate back into place.
• Turn your Macbook on and and go to About This Mac to confirm new RAM installed.

How to upgrade RAM on a Mac Mini

Due to the form factor of the Mac Mini, it is one of the more challenging devices to upgrade. We recommend getting help from professionals or someone that has experience upgrading Mac Mini RAM.

The final word on Mac RAM upgrades

In this guide we showed you how to identify high memory usage on your Mac using macOS and the ever-useful CleanMyMac X. We then outlined the steps to determine what RAM your Mac has installed, whether it can be upgraded, how to purchase new memory for your Mac and finally how to install your new RAM into your Mac.

Once your new RAM is installed, depending on how much you were able to add, you should see a considerable boost to your Mac performance.

Now you know how to upgrade my Mac memory. Hope this article was helpful.

The RACs certainly have our attention.

The MACs (i.e., Fiscal Intermediaries (FI) and Carriers and Medicare Administrative Contractors), however, deserve as much if not more of our attention. Consider this:

The June 2008 CMS program evaluation of the RAC demonstration reported $992.7 million in overpayments collected from providers. But additionally, in a similar time period, the Medicare claims processing contractors (i.e. the MACs) in New York, Florida and California corrected more than $13 million in improper payments and prevented an additional $1.8 billion in alleged improper payments by denying claims before they were paid. Unlike RACs, which perform revisions only after a claim has been paid, Medicare claims processing contractors may review claims or choose claims for medical review automatically before they are paid. The $1.8 billion figure includes both automated and complex prepay review.

The math alone indicates that MACs may be of more concern to providers than the RACs. Additionally, MACs can impose 'severe administrative action,' such as 100 percent prepayment review, payment suspension and use of statistical sampling for overpayment estimation of claims.

Despite evidence of the significant financial impact MAC activity can have, providers appear to be less reactive to MACs than to the RACs. For instance, CMS has reported that providers chose to appeal only 14 percent of RAC claim determinations, with 4.6 percent overturned on appeal.

By comparison, from FY 2005 through FY 2007, Medicare claims processing contractors in all states denied 312 million claims, and providers chose to appeal only four percent of those determinations (12.2 million claims). Only 2.3 percent (7.2 million claims) of those were overturned on appeal.

Query: Are MACs more capable of determining alleged improper payments than RACs, or are providers simply more complacent with respect to MAC denials and/or unprepared to respond to MAC denials?

So what is a provider to do?

I suggest that if you have not done so already, convert your 'RAC Team' into a 'Medicare Team' to expand the scope of your preparedness and prevention activities. Furthermore, a 'RAC Tracking Tool' probably is not sufficient. Optimally, all Medicare denials should be tracked on one platform.

One task on your Medicare Team's agenda should be reviewing the Medicare Program Integrity Manual, which provides information on the various Medical Review (MR) programs.

CMS contracts with carriers, FIs, Zone Program Integrity Contractors (ZPICS - formerly Program Safeguard Contractors) and MACs to analyze data, write local coverage determinations (LCDs), review claims and educate providers. All of these entities are referred to by CMS as Medicare 'contractors.'

Contractors may perform medical review functions for all claims appropriately submitted to a Medicare fiscal intermediary, Medicare carrier, Part A and B Medicare administrative contractor (A/B MAC) or durable medical equipment Medicare administrative contractor (DME MAC).

The goal of the medical review program is to identify and address billing errors tied to coverage and coding rendered by providers.

With respect to errors, CMS acknowledges that most do not represent fraud since most are not acts that were committed 'knowingly, willfully, and intentionally.' However, CMS states that in situations in which a provider has submitted claims in error repeatedly, the MR unit shall take additional action.

Examples of additional actions include the following:

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• Provider notification or feedback and re-evaluation after notification;
• 100 percent prepayment review;
• Payment suspension;
• Use of statistical sampling for overpayment estimation of claims.

Obviously, it is of critical importance for your 'Medicare Team' to implement a process that ensures claims are not submitted in error repeatedly. Hence the need to do the following:

• Vigorously defend and appeal all wrongfully denied claims.
• Track all Medicare denials on one platform for feedback purposes.

MAC Facts to consider:

MAC Fact 1:

MACs can request documentation from a third party if they simultaneously solicit the same information from a billing provider or supplier. Some examples of third parties include a physician's office (if a claim is for lab, x-ray, or Part A service requiring medical documentation) or a hospital (if a claim is for physician's inpatient services). Beneficiaries are not third parties.

But here is the problem:

If information is requested from both the billing provider or supplier and a third party (i.e., a physician's office) and no response is received from either within 45 days of the date of the request (or extension), the contractor will deny the claim, in full or in part, as unreasonable and unnecessary.

If information is requested from both the billing provider or supplier and a third party, and a response is received from one or both but the information fails to support the medical necessity of the service, the contractor shall deny the claim, in full or in part, using appropriate denial codes.

Therefore, payment of a hospital's inpatient Part A claim could depend upon a physician's office supplying requested documentation in a timely manner. Since so much is at stake with simultaneous documentation requests, your Medicare Team should consider implementing a process to follow up with the other parties to ensure compliance with the documentation request.

MAC Fact 2:

MACs may choose to deny claims without reviewing attached or simultaneously submitted documentation when 'clear policy serves as the basis for denial, and in instances of medical impossibility.' It is concerning this that CMS defines 'clear policy' as follows:

'The term ‘clear policy' means a statute, regulation, NCD, coverage provision in an interpretive manual or LCD that specifies the circumstances under which a service will always be considered non-covered or incorrectly coded. Clear policy that will be used as the basis for frequency denials must contain utilization guidelines that the contractor considers acceptable for coverage.'

In my experience, utilization guidelines, LCDs and even NCDs are often subjective and open to interpretation. If MACs choose to decline review of 'simultaneously submitted documentation,' it appears that even provider appeals may not be reviewed. Accordingly, an appealed claim may not receive any type of fair consideration until the Administrative Law Judge level.

In conclusion, our plates are full with RAC preparedness, but there is every reason to expand the scope of our efforts to meet the challenges presented by other Medicare contractors.

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This blog originally appeared at RACMonitor.com.

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