We received more than 700 responses from case management professionals from all over the country. This article focuses on how case management professionals' credentials, experience, and education affect salary.
From the Important Message from Medicare to the discharge instructions, case managers juggle a myriad of forms throughout a patient stay. CMS added another form to the list when it implemented the face-to-face encounter requirement for home health referrals.
When Carolyn Taggett, RHIT, director of health information services at Northern Maine Medical Center in Fort Kent, found that it sometimes took weeks for coders to receive answers to their physician queries, she decided there had to be a better way.
Jean Stone, RHIT, CCS, has never met some of the coders who report directly to her. She has, however, spoken with them by phone, and in some cases, she has seen their wedding or other photographs. This is because nearly all members of her department work remotely.
To take a proactive approach to the RAC process, you will need to assess your current level of financial risk. You can do this internally or with the help of external resources. There are many good risk evaluation software tools on the market for hospitals and health systems; there are also consultants who specialize in reviewing hospitals' claims for proper coding and documentation to assess overall compliance risk and make suggestions for corrections. Once you identify and quantify your risk, you can begin to take action to mitigate the impact of a RAC audit of past claims and to improve your systems to avoid being out of compliance in the future.
