Recovery Audit Contractor Defense: Appeals Process
Product Description:
Our faculty provides a thorough discussion of how to appeal RAC determinations. The session will cover a multitude of topics, from an overview of the timelines to specific strategies to help you get all team players ready to respond to RAC requests.
Session Overview:
Featuring case studies from Lenox Hill Hospital, Methodist Hospital, Sarasota Memorial, and Executive Health Resources, this session will explore enable to you to:
- Fully understand the Medicare appeals process
- Understand the five levels of appeals
- Stay Medicare compliant by having a concurrent certification process
- Understand the need for collaboration among the various hospital departments to successfully appeal RACs
- Determine whether or not you should appeal and rebill
- Learn from others’ experiences
Bonus Resources Include:
- RAC tracking tool
- Process workflow
- RAC coordinator job description
- Methodist Hospital samples of CMS request letters and appeal letters
RAC Ready & Compliant
HCPro, Inc. has determined this program meets one or more of the following criteria:- The main topic contains substantive information about a RAC-identified error
- The program will help you in your appeals preparation
- The program will help you operationalize your RAC strategy/process
About the faculty:
ROBERT R. CORRATO, MD, MBA, as founder of EHR in 1997, is president and chief executive officer. Prior to founding EHR, he held the post of deputy director of the office of health policy and clinical outcomes at Thomas Jefferson University, Philadelphia, Pa. An internist with extensive outpatient, inpatient, academic and community-based clinical practice experience, he is one of only six physicians in the U.S. to have completed medical fellowship training in managed care/administrative medicine. He often serves as a featured speaker at healthcare industry events, has been published in leading healthcare journals, including the Journal of the American Medical Association, sits on the editorial boards of numerous healthcare publications, and has served as a peer reviewer for the Annals of Internal Medicine.
YVONNE FOCKE, RN, BSN, MBA, is a national revenue cycle consultant who has conducted training and education sessions for hospital clients as part of HCPro's Revenue Cycle Institute. She is currently the director of revenue cycle management at St. Elizabeth and St. Luke Hospitals in Northern Kentucky and a presenter on the national stage for professional organizations including HFMA, ACMA and NAHAM.
STACEY LEVITT, RN, MSN, CPC, is director of patient care management at Lenox Hill Hospital in New York City. She has a solid clinical nursing background in both critical care and public health. Her ongoing administrative experience includes over twenty years in healthcare management settings in New York and Pennsylvania. Her areas of expertise include utilization and denial management, reimbursement analysis, performance improvement, professional staff development, and project management. She is known for her in-depth knowledge of Medicare regulations and her passion for effecting increased efficiency, productivity, mastery of insurance coding rules, and realization of appropriate reimbursement. She is an expert in data management and analysis relating to hospital and physician reimbursement.
DENISE MORRIS, RHIA, CCS, is Senior DRG coordinator at Sarasota Memorial Health Care System in Sarasota, FL and has 23 years of experience in HIM, ranging from coding auditor for the Florida QIO to coding instructor. She is a former HIM director, and was part of a team that created a Physician Electronic Practice Management system.
TANJA TWIST, MBA/HCM, is director of patient financial services at Methodist Hospital of Southern California in Arcadia. In her current position she is responsible for oversight of the admitting and business offices at Methodist Hospital, a 460-bed, not-for-profit hospital serving the central San Gabriel Valley in California. She has been in healthcare management for more than 20 years and is the current national finance chairperson for the American Association of Healthcare Administrative Management (AAHAM), the government relations chairperson for the Southern California chapter of AAHAM, and a current member of the Healthcare Financial Management Association (HFMA). She also sits on the advisory board of HCPro, Inc.’s The RAC Report.
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