A Pragmatic Approach to Building a RAC and Multi-Payer Audit System
JoAnne Gitchell, RN
RA Coordinator, Health Information Management
Lake Regional Health System
Professional Services Manager, Audit and Denial Systems
There is a significant rise in RAC audits and take-backs that are now affecting hospitals' bottom lines. This is compounded by MAC, OIG, and commercial payer audits that all have differing requirements and exacting deadlines. The challenge is managing the increasing volume of complex RAC audits and appeals, while also understanding multi-payer requirements and implementing sustainable best practices for them.
Lake Regional Health System outlines the steps they have taken to build, and automate, a robust audit management process with limited resources to manage the onslaught of all payer audits. Lake Regional identified key success factors to streamline the multi-payer audit environment, including a pragmatic approach to audit tracking that meets all deadlines, an inter-departmental RAC Team with lines of communication that enable success for complex audits, management of time and schedules in order to meet demanding deadlines and facilitate successful appeals, and decision criteria for outsourcing the appeals process.
After This Webinar You Will Be Able To:
- Develop a proactive audit tracking plan.
- Prioritize work load and minimize the chaos.
- Improve workflow to handle the ever-increasing number of multi-payer audits.
Tools & Takeaways
- Tips for a bootstrap approach to building an automated audit process
- Automated tools for tracking priorities and knowing the status of each claim at any stage of the process
- Time-tracking tips to stay ahead of the curve
- Sample reports that engage other departments and communicate successes
CEOs, CFOs, revenue integrity directors and managers, and chargemaster managers
Field of Study: Specialized Knowledge and Applications
Delivery Method: Group Internet
HFMA members: Free
Note: This on-demand webinar is available until Jan. 13, 2015.