Health Information Management

Is your hospital owed money for PACTs?

Briefings on Coding Compliance Strategies, July 1, 2009

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The job of the recovery audit contractors (RAC) is twofold: Identify overpayments to recoup excess money and identify underpayments to ensure hospitals receive the money they deserve. Most hospitals are aware of—and expect—the former. But few anticipate getting money back after a RAC audit.

It’s certainly possible for RACs to realize an underpayment, particularly related to post-acute care transfers (PACT), says Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at HCPro, Inc., in Marblehead, MA. In fact, the RAC demonstration project revealed that PACTs represented a significant area of underpayment for hospitals.

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