RAC Case Study - Piedmont Healthcare in Atlanta
RAC Experiences at Piedmont Healthcare in Atlanta
About a year ago, administrators at Piedmont Healthcare in Atlanta established a RAC team to prepare for possible audits. The system includes four hospitals and two large employed-physician practices
The 20-person team includes:
- Billing, or patient financial services
- Medical records and coding
- Case management staff, who have historically managed medical necessity issues, a focus of RACs
"This process requires absolute coordination between team members, particularly the clinical teams, medical records, and finance," says Ken Schwartz, Vice President of Compliance. He recently hired a staff member, called a government appeals coordinator, to manage the process.
Piedmont has also added a claims tracking tool, which allows different departments to monitor their deadlines during a RAC audit.
Publication Date: Tuesday, September 29, 2009