Recovery Audit Contractors

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Briefings on Coding Compliance Strategies
presented on March 11, 2008

Find out what’s on the RACs radar, streamline your requests

Special 2-hour roundtable discussion with professionals who have gone through the process

The recovery audit contractor (RAC) program—an initiative to ensure proper Medicare payments to healthcare providers—may be active in your state sooner than you think. A RAC demonstration program has been active in three states since 2005, and the Tax Relief and Health Care Act of 2006 calls for a nationwide implementation of a permanent RAC program no later than 2010.

Preparing for RACs now is essential because of the enormous pressure that responding to requests could place on your staff. You may also have to hand over funds from claims that were overpaid and potentially go through a lengthy appeals process.

But you can be one step ahead of that process by listening to HIM professionals who have experienced—and survived—RAC implementation. Don’t miss this special 2-hour roundtable discussion during which professionals from California, Florida, and New York explain how they prepared for a RAC review, what the RAC found, and how they are handling requests and appeals today.

You’ll learn how to build a RAC team that can keep up with a heavy workload of requests and appeals, as well as track and trend data. Plus, you’ll learn tips and tricks to help you streamline RAC requests.

AGENDA

1. Review of the role of RACs
1. What are they looking for?
2. Highlights of the general process
2. The RAC timeline
1. Nationwide in 2010
2. The guidelines for California, Florida, and New York and how they may differ from the national rollout
3. Roundtable discussion with the following individuals:
1. Adriana van der Graaf, MBA, RHIA, CHP, CCS (the California experience), Denise Morris, RHIA (the Florida experience), and Allison Bloom, MBA, RHIA (the New York experience)

1. Discussion of summary of RAC findings on the following topics:
1. One-day stays
2. Medical necessity
3. Coding
4. Billing anomalies
2. Overcoming operational challenges
1. Assembling a RAC team
2. Workflow coordination with the chargemaster
3. Appeals process
4. Staffing impact
5. Relations with medical staff
6. Tracking and trending data

2. The future of RAC: Expansion of the RAC program into the physician services arena

A question and answer session follows the program.

LEARNING OBJECTIVES

By the end of the program you’ll be able to:

1. Explain the newly expanded role of RACs
2. Discuss common findings from experiences with RACs in California, Florida, and New York
3. Describe the RAC implementation timeline
4. Determine possible steps that your facility needs to take to prepare for a RAC review, including the assembly of a RAC team
5. Prepare for a RAC review by identifying operational challenges and tracking/trending data

BONUS TOOLS

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and:

These materials are provided with PDF links.

MEET THE SPEAKERS

Kathy Johnson, RHIA, is the director of coding services at Care Communications, Inc. in Chicago. She directs a team of HIM professionals delivering temporary coding, abstracting, coding quality reviews and education. Johnson has 30 years health information management experience in a variety of health care settings. She has done national speaking and authored articles on revenue integrity and coding issues.

Adriana van der Graaf, MBA, RHIA, CHP, CCS, is the privacy officer and director of HIM for the Community Memorial Hospital and Health System of San Buenaventura, in Ventura, CA. She has more than 20 years of experience in HIM, ranging from a diagnostic coding instructor to many years as a director, and has been responsible for overseeing the medical records functions and policies of numerous separate clinics with staff working in multiple areas.

Denise Morris, RHIA, is a DRG coordinator at Sarasota Memorial Health Care System in Sarasota, FL. She has 23 years of experience in HIM, ranging from coding auditor for the Florida QIO to coding instructor, various supervisory and managerial responsibilities in HIM, and as a member of a practice management systems development team.

Allison Bloom, MBA, RHIA, is the director of HIM at NYU Medical Center, where she oversees inpatient and outpatient HIM services and systems. With over 12 years of professional experience, she is uniquely qualified in all aspects of health information management, including administration, information technology, compliance and financial planning, and management.

WHO SHOULD LISTEN?

HIM directors, coding managers, and staff; CFOs; patient financial services; billing managers and staff; utilization review and case management managers; quality assurance managers; compliance officers.

Purchase a CD or audio archive of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.

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