GoingToMeet

Hear precisely how:

* AtlantiCare Health System established an audit process to routinely monitor physician coding and documentation supporting billed services in order to signal to the OIG that the organization is serious in being proactive to ensure physician billing complies with CMS rules and regulations.
* Mount Sinai Medical Center examines lessons learned from participating in 18 Medicaid audits from April 2007 to present, with a focus on the New York State Inspector General’s fraud and abuse program.
* Sisters of Charity Providence Hospitals performs intensive internal audits to identify weaknesses such as billing and admission criteria. Result— an effective, compliant process that establishes revenue integrity and a compliant ROI.
* Glens Falls Hospital established a functional approach to the RAC including resource allocation to handle volume and a project management approach to achieve performance improvement. Result—cost savings and revenue improvement.
* Adventist Health developed a standard reporting tool on a system intranet to track RAC activity.
* Bon Secours St. Francis Health System’s case management department has collaborated with its central business office to implement specific edits in their electronic billing system to catch all codes for “incorrect discharge status.” Result—looking forward to a 100% compliance rate.