Updated on: June 22, 2012

RAC Request: Preparation, Submission More Involved Than Originally Thought

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Original story posted on: June 1, 2010

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The following is the first in an occasional series of articles from the field, reported by Anissa Fabrizio, the Administrative Director of Health Information Management and Patient Access for St. Anthony Hospitals, part of Centura Health.

 

 

I have processed my first RAC request!

 

Colorado Hospitals received its first RAC requests on April 16, with a due date of May 31. My facility has a medical record request limit of 65 records. Our letter had 36 records requested, however one record was not eligible for review as it was not an approved DRG, so it was removed from the list (leaving us with 35 records to submit).

 

I have to admit that the preparation and submission process for these records was much more involved than that of any other record request we've processed in the past. Once our letter was received (it was dated April 16, but received April 23), we immediately began pulling records. The records then were given to our release of information vendor to start creating PDF files. Our record is a hybrid record, in which we have electronic images as well as paper documents that need to be combined to create our entire file. Our ROI vendor had some challenges creating our PDF files due to the large size of our records - the records were being split into multiple PDF files when we needed them to be one file. Our average record page count is around 236 pages; our smallest record was 99 pages, while our largest was 592 pages. Having an electronic database certainly has increased the number of pages in our records!

 

After we overcame our record compilation challenges, the PDF images for each record were saved onto a shared drive for me to be able to access the files and save them onto a CD. I personally reviewed each page in every record to ensure the images were legible and that all requested documents were included. We did need to make some adjustments on some of our files.

 

Our corporate office created the Metadata file that also was needed by populating all of the fields except the requested claim number and number of pages of each file; this information was added for each record.

 

Next it was time to create our CD! Although I had created a test CD a few months ago, there's nothing like the REAL thing! I was holding my breath through each step, but it went seamlessly! The password protection worked, the files were able to be viewed on the CD after it was created - all was well!

 

After our CD was created, I then updated our tracking software and saved our record images so we can retrieve them later along with our updated Metadata file reflecting our page counts and record copy dates.

 

The last step was to put the CD in the mail and send it on its way. The CD was labeled, placed in a tamper-proof envelope and mailed to Connolly Healthcare via overnight shipping. The CD has arrived at its destination and we now will be waiting anxiously for our first response back on our complex record request!

 

About the Author

 

Anissa Fabrizio, RHIA, CCS is the Administrative Director of Health Information Management and Patient Access for St. Anthony Central Hospital in Denver, Colorado. Sponsored by Catholic Health Initiatives, St. Anthony Hospitals is part of Centura Health, Colorado's largest family of hospitals and health care services and one of the state's largest private employers, operating 12 hospitals, seven senior living communities and home care and hospice services. Anissa has had various roles within HIM for the past 18 years, and currently serves as the Treasurer for the Colorado Health Information Management Association.

 

Contact the Author

 

anissafabrizio@centura.org

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