Making sure patients are prepared for discharge can be a tricky process. When certain laws are considered, getting patients to their next destination becomes even more complex.
Case managers have already become familiar with the Medicare Recovery Audit Program. In January, however, government Recovery Auditors began focusing on new territory: Medicaid claims.
Editor's note: Each year HCPro's Revenue Cycle Institute reports on the experience of providers related to the Recovery Audit Program. The article below is adapted from the 2011 Recovery Auditor Benchmarking Report, released in early 2012. The summary of last year's results is by Kimberly Anderwood Hoy, JD, CPC, director of Medicare and compliance at HCPro. Readers can download their complimentary copy of the full report at www.revenuecycleinstitute.com.
If healthcare organizations take a lesson from Blue Cross Blue Shield of Tennessee's (BCBST) $1.5 million settlement for its 2009 HIPAA breach, it's that they should wake up and pay attention to where their ePHI is contained and stored, says Ali Pabrai, MSEE, CISSP, CSCS.
With 20 initial "trial" audits completed, OCR expects to move forward with another 95 audits to measure HIPAA compliance before year's end, said Susan McAndrew, JD, OCR's deputy director for health information privacy. This represents a reduction in the number of audits (150) that were originally planned for 2012.
Sure, you understand the value of investing in improvements that will better protect your organization's PHI. But do the senior leaders who actually hold the purse strings get it?
