Although many RAC issues will continue to be developed thru 2010, there are known vulnerabilities that should be addressed - not simply with filing appeals, but thru changing process to reduce exposure and ensure adherence to the billable requirements.
Class will be three fold:
a) Provide updates with operational 'how to' ideas
b) Provide known audit findings with outcome ideas on how to prevent future problems. Aggressively focus on bad habits! Hybird records vs electronic medical records and the significant risks to audit are incorporated.
c) Provide strategies for what to do once the potential recoupment has been identified.
Updates: The class will address the new issues that are currently available or have been outlined with operational ideas for audit, education, and revenue cycle leadership.
Looking Back: It is imperative that bad habits are aggressively identified with dept head ownership for change implementation. Audit findings will be shared that address hot spots of vunerablity- both complex and automated.
Strategies: Thru audit findings, strategies will be presented that address both decision making thru each step of the appeal process and also action ideas for: pt impact, recoupment vs pay back, interest earned vs interest paid, transmittal impacts, internal action plans and other operational ideas
Appeals: Filing an appeal is a team effort that should include all the stake holders. Costs of action vs inaction will be discussed and presented. Audit findings will be incorporated.
Learning from many different audit findings will be the outcome of the session.