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TEAM BUILDING: Patient access should be ready for RACs

Patient Access Weekly Advisor, August 6, 2008

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Some facilities do not include their patient access managers in a RAC audit preparedness team.

However, according to William Malm, ND, RN, practice director of Revenue Cycle Management at HCPro, Inc., patient access representatives should be included.

“Team members should represent all facets of the revenue cycle,” Malm writes in his white paper, Recovery Audit Contractors: Strategic planning to combat the effects of the RAC program.

Specifically, he says, team members should include:

• Patient access representatives
• Chargemaster coordinators/analysts 
• Physician advisors 
• Revenue integrity auditors 
• Denial management personnel 
• Clinical staff 
• Compliance staff 
• Inpatient and outpatient coding staff 
• Case management staff 
• Utilization review staff 
• Patient financial services/billing staff

As for patient access’s involvement, Malm writes: “Because a form of the RAC focuses on MSP, it is imperative that patient access staff members review this process. Clear policies and procedures based on regulatory guidance need to be reviewed and/or established to ensure compliance. Facilities should train patient access staff members on the MSP and perform competency testing.”

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