RACs Increase Audit Efforts, Encourage Outpatient ProceduresCMS is increasingly relying on its recovery audit contractors to find lost Medicare payments from healthcare providers, and the number of audits increased this past year, with about 90 percent of hospitals reporting recovery audit contractor activity by the end of 2012, according to EHR Intelligence.
A majority of the problematic claims, 61 percent, were denied for single-day inpatient stays when care should have been provided in outpatient settings at lower costs. CMS is also now asking RACs to look at electronic health record templates along with other claim documentation to crack down on cloning, or copying and pasting template information.
In 2012, 60,000 medical records from 1,200 hospitals were called up by RACs, and half of hospitals spent more than $25,000 on the audit process in the fourth quarter of 2012, according to the report.
More Articles on Coding, Billing and Collections:
Collect More From Commercial Payors: 5 Tips for ASCs
Fewer MRI, CT Scans Could Account for Slower Healthcare Inflation
Physician Survey: 27% Would Drop Low-Paying Insurers Despite Patient Population
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