Top 5 Ways Hospitals Are Trying to Improve Claims Accuracy

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.

Advertisement

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.

Read more about CMS’s RAC program.

Advertisement

Next Up in Financial Management

Advertisement

Comments are closed.