Revenue Cycle

Tip: Help prepare your facility for RACs

Patient Access Weekly Advisor, December 23, 2009

Patient access managers can help prepare their facilities for Recovery Audit Contractors (RACs), says Tanja M. Twist, director of patient financial services at Methodist Hospital in Arcadia, CA.

Consider this tip from Twist:

Check on medical necessity. Medical necessity will compose a big part of the RAC audits, Twist says. The admitting department can help the back end review cases to ensure that they make sense. “What you really need is an admitting nurse in there reviewing a physician’s order to make sure it meets medical necessity and Medicare guidelines for medical necessity,” she says.

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