Health Information Management

Identify potential Medicaid RAC target areas

HIM-HIPAA Insider, April 10, 2012

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The Medicaid RAC program kicked off January 1, and experts say that although the program got off to a slow start, activity will likely ramp up in the next few months.

This means that if your hospital hasn't experienced an audit yet, it probably will soon. As audits get under way, specific target areas will begin to emerge as well.

Addressing documentation, coding, and billing problems on the front end is the best way to prepare for Medicaid RACs, says William L. Malm, ND, RN, CMAS.

"Are you putting that effort in on the front end to make sure that the claim is as clean as possible before it goes out?" says Malm, a healthcare consultant at Craneware in Atlanta. "Clearly, the front end [route] is going to be most cost-efficient."

Editor’s note: Read the entire article in the April issue of Briefings on Coding Compliance Strategies.

 



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