Dive Brief:
- In addition to a growth in RAC audits, hospitals are seeing an increasing number of audits by commercial payers.
- While there's comprehensive data available on RAC audits from CMS and the American Hospital Association, it's harder to track level of audits initiated by commercial payers.
- Commercial payer audits are different than RAC audits in several ways. Primarily, commercial audit inspections are conducted on-site and take place much closer to the actual patient encounter.
Dive Insight:
Experts say that hospitals should approach commercial audits in the same organized, thorough way that they handle RAC audits. Hospitals should create a process for identifying and monitoring requests, as well as a quality control procedure to make sure they're doing everything they can internally to track products. Otherwise, providers may end up paying back more than they should.