Revenue Cycle Forum Roundtable Summaries

This is the discussion wrap-up of the topics discussed at the Revenue Cycle Forum Roundtable held on October 27th, 2008 at HFMA's Revenue Cycle Strategies Conference in Las Vegas, NV. 

• Understanding the impact of the RAC program
  • Hospital implications
    • Potential financial impact – cash flow disruption
    • Assess their RAC/Audit readiness
  • Organizational involvement
    • Physician documentation improvement initiatives
    • Improving skills and compliance
  • Reducing future reviews
• Hospital Action Items
  • Assembling a RAC team
  • Workflow coordination
  • Tracking and trending data 

• Identifying and establishing a RAC coordinator
• Developing or obtaining a database (check with state associations on this)
• Conduct RAC analysis with focus on OBS and One day stays – be prepared for the possibility of self disclosure (which will take the accounts off the table for future audits)
• Use Pepper reports, state regulatory criteria if applicable, audit similar cases concurrently before they are billed, and conduct an audit on coding

Solutions should include:

• Nurse over revenue integrity
• Include the Medical director
• Medical CIO
• Documentation nurses
• Corporate compliance committee structure
• Risk – physicians not impacted 

• Current focus on position like coders, transcriptions, etc. move into revenue cycle might include schedulers, pre-registration, etc.
• Works best with people who don’t like people
• Issues include:
  • Equipment, who provides it; hospital or employee; maintenance of equipment, phone lines, security, etc.
  • How do you establish face to face contact, i.e. stay connected with the rest of the group
  • What if you are a union shop?
  • Not a substitute for child care, need to ensure that staff have this resolved
• Alternate Solutions:
  • Flex schedule (staff can arrive between this time and that time and flex their day based on their time of arrival i.e. start at 7:00 leave at 3:00 start at 9:00 leave at 5:00
  • Reporting windows staff can arrive anytime between 8:00 and 8:30 without worry of being deemed late – make up time at end of day (helps for people that can’t control traffic issues, etc.