Original story posted on: December 10, 2008

RAC Preparedness Starts Now

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Updated on: June 22, 2012
With the RAC program expected to roll out in February, healthcare experts are advising hospitals to begin preparing for impending audits.

The best advise: begin preparing now by conducting internal claims audits using data mining or claims analysis software. Use software to carefully track the status of all pending claims audits.

Thirty-three percent of hospitals preparing for RAC have installed new software to capture correct documentation, coding and billing, according to a recently published study conducted by an independent national survey on behalf of Wolters Kluwer Health.
The study also found that 81 percent of the HIM directors reported their facilities are taking steps to improve Medicare claims accuracy.

HIM directors at medium-sized hospitals reported they are most likely (47 percent) to install new software, compared to 16 percent of those at small hospitals and 35 percent of those at large hospitals. Only 18 percent of the HIM directors taking steps to improve Medicare claims accuracy reported their facility has hired additional coders.

According to the survey, coding experts say doctors and hospitals that don't prepare now for the upcoming federal crackdown on Medicare billing could face bills amounting to six figures, referrals to fraud enforcers and possible jail time. 

As the Boy Scouts say, “Be Prepared.”
Bret Bissey, MBA, FACHE, CHC

A veteran in healthcare compliance (since 1997), Bret Bissey has served as senior vice president and chief ethics compliance officer at UMDNJ in Northern New Jersey. The author of the Compliance Officer’s Handbook, he has been a thought leader and popular speaker at industry conferences and meetings for many years. Bissey has more than 30 years of diversified healthcare management, operations, consulting, and compliance experience.

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