If you have read the HIMSS Blog, you’ve seen the posts related to the media coverage on fraud and abuse in healthcare.
One of our guest bloggers on this topic, A. Joe Ferro, President, Claim Assurance, in Hialeah, Fla., continues this discussion with three important tips for healthcare providers on accurate coding and billing. They are:
- The importance of charge capture: Medicare recovers overpayments through Recovery Audit Contracting (RAC). The RAC take-backs are sticking; they are not defensible due to lack of documentation.
- Up-to-date systems: Coding rules are constantly changing, so your compliance systems must be kept up-to-date. Medical necessity policies change weekly. What is your schedule for updates on your systems?
- Internal feedback loop: Hospitals must have a well-defined communications path established throughout the organization. Billing may catch issues, such as medical necessity, but unfortunately, billing is typically not empowered to take corrective action. The claim with issues must either go back to the department or to medical records for repair. Repetitive issues need champions within the organization to make lasting corrections to internal systems and processes.
Health Reform: IT’s Role in Ensuring Compliance with Fraud and Abuse Rules
A. Joe Ferro President, Claim Assurance Wednesday, Nov. 7 3:15 – 3:45 p.m. CT
Register now for the HIMSS Virtual Conference & Expo, “The Impact of Health IT Regulations on Care Delivery.”