Health Information Management

Know how to identify, understand RAC compliance risks

HIM-HIPAA Insider, October 4, 2011

Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

It shouldn't come as a surprise that RACs use the Common Working File (CWF) to ensure that hospitals are reporting discharge disposition codes—otherwise known as patient status codes—correctly.

The good news is that their findings could result in underpayments as well as overpayments.
 
The CWF, which houses all claims data and activity for all patients, allows RACs to conduct automated reviews of the postacute care transfer (PACT) rule and easily data-mine for errors, says Gloryanne Bryant, BS, RHIA, RHIT, CCS, CCDS. Bryant is the regional managing director of HIM, NCAL revenue cycle, at Kaiser Foundation Health Plan, Inc. & Hospitals in Oakland, CA. This major data file shows when patients start and stop certain services, and it also provides insight regarding when they move from one level of care to another, Bryant says.
 
Editor’s note: Click here to read the entire article in the September issue of Briefings on Coding Compliance Strategies.



Want to receive articles like this one in your inbox? Subscribe to HIM-HIPAA Insider!

Most Popular