General Compliance Question of the Week
July 26, 2010
Question:
I know that RACs perform two types of reviews but wondered whether both are being performed on hospital inpatient records?
Answer:
According to findings from a recently completed American Hospital Association Survey (called RACTrac), most recovery audit contractors (RACs) are performing complex reviews for inpatient coding. In a complex review, RACs review medical records and other medical documentation to identify improper payments to providers.
Most automated reviews relate to outpatient coding and billing. In these reviews, computer software is used to detect improper payments.
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