Dive Brief:
- According to Karen Bowden, executive vice president of revenue integrity operations at Craneware, the following are some of the biggest mistakes hospitals make when being audited by CMS.
- These mistakes include failing to analyze the cases they don't appeal; putting too little effort into appeals; rebilling without fully considering the situation and whether an appeal is necessary; failing to track repayment after successful appeals; and maintaining poor documentation which leaves you open to CMS censure.
Dive Insight:
As annoying, frustrating, and even frightening as they can be, RAC audits are a fact of life. Failing to take basic steps to control the process as much as possible may not bankrupt your hospital, but it will leave it very exposed to further regulatory scrutiny. The deliberate approach defined above should be a part of your everyday process if you don't want the RACs breathing down your neck.