10/26/2009: Medicare Compliance Forum: Recovery Audit Contractor Track

On-demand audio recordings of the Recovery Audit Contractor (RAC) track
of HCPro Revenue Cycle Institute's popular Medicare Compliance Forum
held October 26-27, 2009, in Atlanta

This event featured nationally recognized regulatory experts and in-the-trenches healthcare providers addressing key Medicare compliance concerns with practical and innovative approaches for compliance success.

The RAC track provides critical strategies and helpful tools from professionals who went through the RAC demonstration project and are ready to take on the permanent program. Each session is described below.

Purchase all seven sessions for $399 or individual presentations for $79 each. All of the sessions are sold as MP3 downloads. Each session is 60 to 90 minutes in length. Click the appropriate link to add presentations or the entire seven-session package your shopping cart.

For information on Medicare Compliance Forum tracks for Observation Services and Physician Advisors, click the appropriate link.

Individual sessions

State of the Union
The speakers explore demonstration program results and changes to the permanent program, the state of RAC preparedness amongst providers, the mood on Capitol Hill, updates on the rollout of the permanent RAC program, and more.
Speakers: Kimberly Anderwood Hoy, JD, CPC; Michael Taylor, MD

From the Field Panel Discussion
The speakers share stories, experiences, challenges, and victories with the RAC demonstration project. Use their tested recommendations to prepare your facility for RACs.
Speakers: Stacey Levitt, RN, MSN, CPC;Michael Taylor, MD; Tanja Twist, MBA/HCM

A Team Approach to Manage Medical Necessity
This session covers ways to integrate case management and physician advisors; review physician orders for medical necessity; set up criteria in the emergency department; ensure that criteria are met for one-day stays and observation; proper use of the Medicare Secondary Payer Questionnaire; data mining opportunities to determine risk areas; components and typical documentation errors of rehab medical necessity; and RAC implications for rehab services admissions and documentation.
Speakers: Tanja Twist, MBA/HCM; Michael Taylor, MD

Strategies for Coding Compliance
This session covers analysis of top areas found in demonstration project, including debridement and septicemia, and how to conduct proactive audits and ensure proper documentation on medical necessity.
Speakers:  Stacey Levitt, RN, MSN, CPC; Shannon McCall, RHIA, CCS, CCS-P, CPC-I, CCDS

Mastering the Appeals Process
The session covers how to appeal a RAC determination, levels of appeal, options about what to appeal, and timelines and guidelines to operationalize the process.
Speakers: Stacey Levitt, RN, MSN, CPC; Michael Taylor, MD; Tanja Twist, MBA/HCM

One-Day Stays
This session explores how to ensure processes for appropriate admissions, physician documentation for medical necessity, admissions monitoring by case managers, and ED compliance with admissions criteria.
Speakers:  Kimberly Anderwood Hoy, JD, CPC; Michael Taylor, MD

The Perfect Storm: Other Post-Billing Audits
This session covers auditors other than RACs, including Medicaid Integrity Contractors, Comprehensive Error Rate Testing, and Zone Program Integrity Contractors. Learn about audit targets, strategies for risk assessments, lessons learned from experts who have been through the audits, and how to operationalize these audits in tandem with RACs.
Speakers:  Stacey Levitt, RN, MSN, CPC; Tanja Twist, MBA/HCM

Meet the Faculty

Kimberly Anderwood Hoy, JD, CPC, is the lead instructor for HCPro's Medicare Boot Camp ®--Hospital Version and serves a lead consultant for HCPro's Revenue Cycle Institute. She is a former hospital compliance officer and in-house legal counsel and developed and implemented corporate-wide compliance programs for two hospitals.

Stacey Levitt, RN, MSN, CPC, is director of patient care management t Lenox Hill Hospital in New York City. She has a solid clinical nursing background in both critical care and public health and expertise include utilization and denial management, reimbursement analysis, performance improvement, professional staff development, and project management.

Shannon McCall, RHIA, CCS, CCS-P, CPC-I, CCDS, is the director of HIM and coding for HCPro. She oversees both Certified Coder Boot Camp program, is a consultant for HCPro's Revenue Cycle Institute, and is a member of the advisory board for the Association of Clinical Documentation Improvement Specialists.

Michael Taylor, MD, is senior medical director of government and regulatory affairs at Executive Health Resources (EHR) in Newtown Square, PA. Since the start of the RAC demonstration project, Dr. Taylor has worked closely with top hospital executives, physicians, and legal experts to institute a process of sophisticated, evidence-based medical necessity review of inpatient claims denied by the RACs.

Tanja Twist, MBA/HCM, is director of patient financial services at Methodist Hospital of Southern California in Adcadia. She is responsible for oversight of the admitting and business offices.

• Seminars - On-Demand

• Other Finance Products
• Other Revenue Cycle Products