If anything stirs the blood of a healthcare finance executive, it's Medicare's Recovery Audit Contractor (RAC) program. RACs have become somewhat of an obsession in the provider community, with its leaders trying to figure out how to avoid them, dispute them and successfully appeal them.
The reasons are obvious: Successful hospital operations hinge on finding and retaining as much revenue as possible.
"Hospitals will need to be able to respond to denials as quickly as possible in a reform environment to ensure that they are getting the reimbursement to which they are entitled," said Suzanne Lestina, director of revenue for the Healthcare Financial Management Association (HFMA). "Increased focus on a hospital's documentation management and coding practices--ensuring that clinicians are documenting the services that are performed and the medical necessity of the services, and verifying that the charges are matching the services that are being performed--will be key."
Therefore, HFMA's 2011 ANI conference will be a treasure trove of RAC information, with several seminars focusing on the topic.
A trio of healthcare executives will present on Monday the seminar, "RAC: Using New Tools to Avoid Denials and Win Appeals." On Tuesday, Day Egusquiza, president of AR Systems, Inc. in Twin Falls, Idaho, will present "What's New with RAC? Updates, Audit Findings, and Ideas to Reduce Vulnerabilities." Later that day will be the presentation, "Using the RAC Program as a Catalyst to Improve Net Revenue." That will focus on the RAC success stories of St. Joseph's Healthcare System in Paterson, N.J.
Although many other sessions won't focus on RACs specifically, they will provide tools to finance executives that will allow them to address the audits proactively.