Revenue Cycle

RAC talk: A few minutes with Nancy Hirschl

Recovery Auditor Report, November 11, 2010

Name: Nancy Hirschl, B.S., CCS

Title: President

Company: Hirschl and Associates, Laguna Niguel, CA

RAC background: Hirschl has 30 years of experience in health information and revenue management. As president and founder of Hirschl and Associates, Nancy develops, administers, and manages services that address best practices in revenue integrity. Nancy has developed and implemented hospital-based inpatient and outpatient revenue integrity consulting services, Medicare Part C risk-adjusted data mining, auditing and training services, DRG, APC, and RAC data mining software, and training programs.

What are some (or just one) of the most common errors you’ve seen hospitals make when it comes to the RAC process?

One of the most common errors we have seen hospitals make is performing post-discharge inpatient status screening for one-day stays only. Admission screening should be performed on a real-time, predischarge basis. If postdischarge review is the only approach the hospital can take, then inclusion of one, two and three-day stays is essential. The RAC is not going to review only one-day stays for medical necessity purposes.

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