Health Information Management

Revenue Cycle Institute releases '2011 Recovery Audit Benchmarking Report'

HIM-HIPAA Insider, March 6, 2012

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The Revenue Cycle Institute has released a new white paper, “2011 Recovery Auditor Benchmarking Report,” by Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance for HCPro, Inc.

The 2011 report covers topics addressed in prior reports; it also examines providers’ experience with the Recovery Auditors and their preparations to handle requests and appeals. In addition, the report looks at providers’ experience with other auditors.

This year’s survey had 431 respondents representing hospitals of all sizes and from all four Recovery Auditor regions. Respondents were fairly evenly distributed among providers of different sizes, with 21% from small hospitals with less than 100 beds and 31% from larger hospitals with more than 400 beds. Region C had the most respondents, and there was an increased response from Regions A and D, although all regions were fairly well represented.

The responses reflect a big uptick in Recovery Auditor activity with a large increase in respondents reporting both automated audits and records requests. Less than 50% of providers had received an automated audit recoupment last year, but this number is now up to 72%. In addition, more than 80% of providers have received records requests for semi-automated or complex reviews over the course of 2011. This increase in audit activity has led to an increase in the respondents who have had money recouped. Seventy-six percent of respondents have experienced recoupment, leaving only 6% of providers who have received records requests unscathed by recoupments. But with the increase in activity of the Recovery Auditors, we have seen a corresponding decrease in problems with the operations of the Recovery Audit Program as issues have worked themselves out as predicted in last year’s report. For example, the number of respondents having problems with records requests fell from 17% to 8%; other issues related to records requests, other than tracking, were also cited by fewer than 10%.

Access the complete “2011 Recovery Auditor Benchmarking Report” on the Revenue Cycle Institute blog.

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