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Hospitals Expect to Refund Medicare
August 18, 2008
Eighty-one percent of health information management directors at hospitals say their organizations have taken steps to improve claims accuracy to prepare for the Medicare Recovery Audit Contractor program, a new survey shows. Nevertheless, the survey also found that 40% expect to owe funds to Medicare as a result of overpayments identified by the RAC program.
The telephone survey of 171 directors, conducted June 30 through July 8, found that of those that have taken action, 77% had conducted internal claims audits; 66% had implemented a claims documentation improvement plan; and 57% had created a special task force to examine documentation, coding and billing. In addition, 33% said they had installed new software to capture correct documentation, coding and billing. Only 18% had hired additional coders.
Renaissance Research, Edwardsville, Ill., conducted the survey, which was sponsored by Wolters Kluwer Health, a Conshohocken, Pa.-based software company. The participants were selected at random from a list of 4,300 health information directors at hospitals obtained from Medical Marketing Service Inc.
In September, the Centers for Medicare and Medicaid Services plans to select four independent contractors to run the new national Medicare Recovery Audit Contractor program. The program will attempt to identify and recoup overpayments. The RAC program will be phased in state-by-state starting in the fall, says Melanie K. Combs-Dyer, a CMS senior technical advisor. Under the program, independent auditors will review claims, often requesting that providers submit detailed records to demonstrate that the billing was properly documented.
More information is available at wolterskluwer.com.
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