If patients had concerns about the ability of healthcare organizations to protect their ePHI, two government reports released in May did nothing to alleviate their fears.
ICD-10 will affect every system within your hospital. So said Mary Rita Hyland, RN, BS, MBA, assistant vice president of regulatory affairs and chief privacy officer for The SSI Group, Inc., in Mobile, AL, during the March 21 HCPro, Inc., audio conference, "ICD-10 Vendor Readiness: Build Your Game Plan Now." Providers have a significant task ahead of them and a small window within which to accomplish it, Hyland said. And that means taking a good hard look now.
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.
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.
