Coming soon: Recovery auditor prepayment reviews
Recovery Auditor Report, June 28, 2012
Last November, CMS unveiled three demonstration projects aimed at reducing improper payments in the Medicare program. A few months later on February 3, 2012, CMS announced that it would be delaying two of the three of these demonstrations, one of which is the Recovery Auditor prepayment review demonstration.
Though the CMS website lists the start date as “Summer of 2012,” the delay—which came as a result of comments and concerns from providers— originally pushed the the official launch to June 1, 2012. If we are, in fact, in the midst of the Recovery Auditor prepayment review demonstration, there has been no official announcement. Despite this fact, if providers have not already begun doing so, they should take action, according to Sharon Easterling, MHA, RHIA, CCS, CDIP, CEO of Recovery Analytics in Charlotte, N.C.
“With the shift of the RAC to up-front documentation review, providers should implement concurrent processes in their case management and utilization review areas,” she says. “From there, you should have second level review done by a physician for these particular DRGs.”
Related Products
-
Core Skills for Hospital Case Managers:
A guide to fundamental case management responsibilities, Core Skills for Hospital Case Managers serves as a training...
-
The RAC Toolkit for Hospitals and Health Systems
The RAC Toolkit for Hospitals and Health Systems: Manage Responses and Avoid Claims Under the Permanent Program is your...
-
The 2013 Medicare Compliance Forum: Las Vegas, NV
-
Level of Care Determinations for 2014: Las Vegas, NV
Attend the half-day seminar, Outpatient, Observation or Inpatient? Continuing to Walk the Tightrope of Regulatory Guidance...
-
OPPS and IPPS Reimbursement Fundamentals: Las Vegas, NV
Attend OPPS and IPPS Reimbursement Fundamentals, a half-day seminar on October 2nd in Las Vegas. Learn how CMS’ substantial...
Most Popular
- Articles
-
- Don't forget the three checks in medication administration
- Nursing responsibilities for managing pain
- Steps for maintaining patient privacy
- Note similarities and differences between HCPCS, CPT® codes
- Practice the six rights of medication administration
- Q&A: Primary, principal, and secondary diagnoses
- Poor documentation: The consequences
- Know guidelines and subtle differences in code descriptions for laceration repairs
- The consequences of an incomplete medical record
- Neurological checks for head injuries
- E-mailed
- Searched