Health Information Management

Tip of the Week: Form a RAC team to help prepare for national implementation of program

APCs Insider, May 18, 2007

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CMS has announced that the recovery audit contractor (RAC) program will expand nationwide in two phases. This spring, CMS will add one or two states to each of the current RACs' jurisdictions. The agency will also begin the process of selecting four RACs to bring the program nationwide by 2010. Experts agree that now is the time to prepare for the coming changes.

Because the RACs' reach is so broad--including inpatient, outpatient, and rehab records--the first step for most hospitals should be to form a RAC team, says Gloryanne Bryant, RHIA, CCS, corporate director of coding/HIM compliance for Catholic Healthcare West in San Francisco. Nancy Hirschl, president of Hirschl and Associates in Laguna Niguel, CA, suggests that you include members from the following areas:

  • Finance
  • HIM
  • Compliance
  • Case management/medical staff

Depending on your outpatient-related findings when the RAC comes to your state, consider including a clinical department head as well. The members of your RAC task force should familiarize themselves with the 2006 RAC Status Report (available at www.cms.hhs.gov/RAC), Bryant says. They should also look to improve coding and documentation quality processes in advance of a RAC arrival.

(The above tip appeared in the May 2007 Briefings on Coding Compliance Strategies).



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