Cheryl E. Servais, MPH, RHIA, has more than 25 years of experience in health information management. In her position at Precyse Solutions, Ms. Servais' responsibilities include planning, designing, implementing and maintaining corporate-wide compliance programs, policies and procedures, and updating them to accommodate changes in federal and other regulations.
Cheryl Servais
Two recent publications issued by CMS clearly indicate that the organization is tightening its requirements for the documentation required to support medical necessity and mandated signatures on prescriptions and orders for services.
We all suspected it, but now it's official: RACs will be providing information to CMS for follow-up on cases of possible fraud.
Our preliminary statistics indicate that more than half of RAC findings for complex reviews should be rebutted due to documentation that was overlooked or guidelines that were not applied correctly.
We all know that the RACs are here, but what should we be doing to be in the best position to minimize the stress that their audits could cause? The controller at a Kentucky hospital has some suggestions.
The RAC Web sites are starting to post more information relating to the details of their complex review processes, to the benefit of providers everywhere.
Imagine a healthcare system in which providers do not have to prepare and submit bills. No ICD-9-CM or CPT coding, no MS-DRGs, no charge master or charge capture, no DNFB.