Top 5 Ways Hospitals Are Trying to Improve Claims Accuracy

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Written by Stephanie Wasek

Tuesday, 19 August 2008

Ninety-two percent of hospital health information management (HIM) directors are aware of CMS's Recovery Audit Contractor (RAC) program, which aims to root out claims paid in error, according to a survey conducted on behalf of Walters Kluwer Health Clinical Solutions and ProVation Medical. In light of the federal government's efforts, 81 percent of HIM directors are taking steps to improve Medicare claims accuracy.

Here are the top five ways hospitals are doing so:

1. conducting internal audits (77 percent);
2. implementing a documentation improvement plan (66 percent);
3. creating a special task force to examine documentation, coding and billing (57 percent);
4. installing new software to capture correct documentation, coding and billing (33 percent); and
5. hiring additional coders (18 percent).

Of the HIM directors familiar with the RAC program, only 5 percent believe it will have a positive financial impact on their facility due to recovery of funds from Medicare underpayments. Rather, 88 percent either anticipate a negative financial impact due to their facilities owing funds for Medicare overpayments (40 percent), or anticipate their facility will come out about even (48 percent).

Renaissance Research conducted the national survey of 175 hospital HIM directors on behalf of ProVation Medical. Learn more about ProVation.