Recovery audit contractor (RAC) activity is picking up, but many healthcare providers are still waiting to see whether their preparations have paid off, according to a January survey of more than 400 healthcare providers conducted by MRB. Eighteen percent of survey respondents had received medical record requests (i.e., additional documentation requests) as of the time of the survey. Only 8% of providers received RAC denials.
As recovery audit contractors (RAC) begin to roll out complex reviews and request medical record documentation, compliant coding will continue to take center stage. And although correct coding is vital, sequencing codes is equally important because it affects MS-DRG assignment and payment.
Memorial Hermann Healthcare System (MHHS) in Houston includes nine acute care hospitals, one children's hospital, three long-term acute care hospitals, three specialty care hospitals, 21 regional affiliates, a home health agency, a retirement/nursing center, 10 ambulatory surgery centers, 21 imaging centers—and only one HIM department.
Prior to July 1, 2008, however, that was not the case. MHHS' medical records/HIM departments used to be facility- based. Each hospital had its own medical records department, its own coders, and its own vendors. But MHHS' leadership recognized that in an era when cost savings are a must, this model was not as efficient as it could be. A restructuring of the department was in order.
Sarah Bush Lincoln Health Center in Mattoon, IL developed a productivity incentive plan for their coders and transcriptionists. For the hospital, the bonus plan serves as a retention and marketing tool, not to mention it has increased productivity, and the staff members appreciate it, too.
On December 30, 2009, the Office of the National Coordinator for Health Information Technology published the interim final rule for EHR certification standards, and on January 13, CMS issued the proposed rule on the EHR Meaningful Use Incentive Program and meaningful use standards in the Federal Register.
