Case Management

Mentor moment: Revenue Cycle Institute releases 2010 RAC Preparedness Benchmark Report

Case Management Weekly, December 15, 2010

The results of HCPro’s second annual “RAC Preparedness Benchmarking Report” are in, and case managers continue to be a large part of RAC preparedness efforts.

A total of 459 providers representing facilities of all sizes from each of the four RAC regions responded to the survey.

According to the results, many facilities have had minimal contact with their RACs. More than 50% of respondents have not had recoupments related to automated audits, and nearly 40% had not received a record request for a complex audit.

Despite the lack of contact with RACs, a greater percentage of facilities have a formal RAC program (90%). That’s up 20% from 2009. More than half of the respondents (63%) also have designated a RAC coordinator. The most common background for RAC coordinators is HIM/coding (29%), followed by case management (18%).

Looking to the future, 41% of respondents said medical necessity and one-day stays are their main focus for RAC preparations going forward. Case managers play a key role in determining medical necessity and will no doubt continue to be a large part of RAC preparation efforts.

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