Recently one of our hospital clients had a Third Party Audit Firm sneak a request for records past a new person. In my article titled “Your Losses Begin in Medical Records” you’ll see that releasing medical records needs to be carefully considered. In any case these...
As we explored previously in our first article stopping loss can occur. Here’s how it starts: Identify and consolidate your findings in these areas: 1. Government Audits 2. Commercial Audits 3. Business Office Denials Most sites will keep these areas separate,...
Your Audit Losses – Step One Of all the sites I’ve ever consulted for there is always the same pattern and posture with auditing. Some are better than others but all have divided the audit losses into generally three categories. 1. Business Office Denials 2....
Great article I thought I’d share by Brad Flansbaum IF CONGRESS PLANS ON FIXING THE RACS IN 2015, THEY NEED TO READ THIS FIRST! • February 24, 2015 • Brad Flansbaum The recent increase in observation stays has led to a surge in federal oversight and scrutiny. We have...
In the world of being an expert it can take careful observation as to what is occurring in your area of expertise. This has become especially true in the world of auditing. It is true in the realm of RAC as CMS offers loads of grey areas, and an ever moving target of...
Effective December 4, 2014, membership in AAMAS is no longer a CMAS requirement. The Council recognizes the many relevant organizations that work with our core mission. Therefore, membership to a revenue integrity organization or quality management organization is now...
As health plans attempt to measure the acuity of new patients through the Affordable Care Act’s healthcare marketplace exchange, hospital audit teams will see a huge influx of commercial risk adjustment audits and associated medical record requests. And the deluge is...
Good information I thought I’d share. Thanks Evan Godt. Evan Godt, Jan 14, 2015 The HHS Office of Inspector General’s (OIG) Fiscal Year 2015 Work Plan includes three ongoing imaging-related projects, according to the American College of Radiology (ACR). OIG’s annual...
CMS recently published RAC changes as they prepare to have the RAC program get back into full swing. The final determination for the fifth RAC has been confirmed as Connolly. Here are some of the changes based on provider concerns: ADR limits will now be established...
