ICD-10 CMS Implementation Planning

CMS has commissioned implementation reports and impact analyses for its internal use in preparing for the ICD-10 and Version 5010 transitions https://www.cms.gov/ICD10/04_CMSImplementationPlanning.asp#TopOfPage

CodingAID

A Division of Managed Resources, Inc.

 
RAC Review & Appeals PDF Print E-mail

RECOVERY AUDIT CONTRACTOR REVIEWS

Preparing for the RAC audits is one of the most important areas of concern for hospitals today. CodingAID, a division of MRI, has been helping organizations nation wide by providing them with a comprehensive assessment of RAC Risk, Appeals & Tracking Services and Physician & Coder Education to proactively reduce future RAC audit exposure.

Since 1994 CodingAID (MRI) has been providing hospital finance and coding reviews, and we are especially qualified to assist hospitals in determining where their greatest vulnerabilities in the RAC review process lies. It is our goal to help provide our clients with the necessary confidence and expertise that their organizations need in order to be able to withstand a RAC audit.

CODINGAID’s APPROACH

From assessing risk to setting up a mechanism for handling the review and appeal process, it is imperative that your facility be ready for the inevitable visit of the RAC reviewers. We are ready to assist in these areas:

Risk Identification:

  • CodingAID will assess any existing areas of risk to your facility by performing a comprehensive audit of selected inpatient and outpatient charts
  • Identification of documentation inaccuracies and coding assignment risks are a few of the first steps in the preparation process for the RAC review
  • CodingAID’s review will include a review of medical necessity documentation practices, validation of MR-DRGs, and appropriate selection of principal diagnosis

RAC Demand Letter Review & Appeal:

  • All RAC demand letters will be forward to CodingAID for review. Our team of highly experienced HIM Professionals will assess each case in question for completeness of documentation, medical necessity and coding accuracy.
  • Each RAC case will be tracked by CodingAID and customized progress reports will be issued periodically
  • Appeal letters will be prepared by CodingAID along with all necessary documentation on justifiable cases

Trend Reporting & Education:

  • CodingAID will analyze and provide trend reporting on all RAC cases in order to spotlight all issues that are causing denials
  • Recommendations will be provided to help reduce future RAC audits
  • CodingAID will provide onsite or web-based Physician and Coder education
 

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