RACs
Recovery Audit Contractors (RACs)
Let MedLearn help you understand and prepare for RACs. We'll help you protect
your bottom line. We provide focused analysis on the same areas targeted
by RAC audits. We'll perform a customized MS-DRG improper payment risk analysis
on your data and measure it against the Centers for Medicare & Medicaid
Services (CMS) benchmark reports. This provides the data you need to proactively
address areas of financial exposure.
Client Benefits
- Understand and manage improper payment risk
- Establish RAC performance plan and benchmarks
MedLearn Approach and Objectives
Data Analytics and Findings:
- Analyze your at-risk MS-DRGs targeted by the RACs
- Validate medical necessity risk, coding risk and opportunities
- Conduct onsite, mini-operational assessment identifying gaps in people,
process, and technology to analyze root causes contributing to improper
payment
Implementation and Reporting
- Establish accountable performance improvement plans
- Implement internal controls and monitoring plans
- Report and measure progress through key metrics and benchmarks
Carol Spencer, BA, RHIA, CCS, CHDA
Senior Healthcare Consultant
Carol is a thought-leader on data analytics with extensive CDIP and RACs
experience. She is the MedLearn project lead on A-Life Medical Inc. coding.
She brings more than 20 years of experience in Health Information Management,
coding, teaching, data quality and operations. Carol holds a BA in Health
Information Management and an RHIA. She is an accomplished teacher, author,
and speaker covering subjects/topics such as: CPT and ICD-9-CM coding, Physician
Office Coding/Billing, Medical Terminology, and financial and compliance
impacts of the MS-DRG rule change and compliance strategies.
Affiliations
- Certified by National Medicare RAC Summit
- Certified Health Data Analysis (CHDA) with AHIMA
- Former co-chair of AHIMA for professional development committee and education
committee
- Colorado HIMA active member
- Former Minnesota HIMA member
Previous Experience
- Manager, Professional Practice Resources, Coding and Reimbursement for
AHIMA.
- Coding compliance and reimbursement experience in both technical and professional
billing at many levels of hospital and corporate structures, including:
facility Manager/Director of HIM; Independent Coding Consultant; corporate
Senior Consultant Coding Compliance and Regulatory Compliance Support.
- Professor of HIM courses at the community college and university level
as well as corporate settings.
We offer a free inpatient, no obligation, mini-assessment service. Call 1.800.252.1578 ext. 3437 to find out more.
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