MEDICARE RAC Certificate Program
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The pace of hospital audits by RAC and MAC contractors in Medicare has been fierce since the 2012 Summit, not to mention aggressive Medicare Advantage audits, active Medicaid RACs, and the occasional OIG audit. Hospitals' rightful appeals of the growing body of Medicare FFS denials in turn has completely overwhelmed an understaffed collection of Administrative Law Judges, whose 90-day timeframe for a hearing is now up to a year and more. Changes in the RAC Scope of Work and likely in at least some of the contractors themselves have provided added uncertainty, but none more so than the new IPPS rule and its "Two Midnight" standard. Never has it been more important for hospitals to "get it right the first time" when it comes to proper documentation of medically necessary patient care and proper decisions regarding whether a patient should be admitted to inpatient status, placed into Observation status, or treated in an outpatient setting.
The Eighth National RAC (and MAC) Summit is the "must attend" event of the year, bringing together in one conference all of the major perspectives -- RAC, MAC, QIC, ALJ, and the AHA response -- plus the two primary sources of screening criteria, InterQual and Milliman Care Guidelines. The ability to interact with these major players is combined with presentations from leading hospital and hospital association representatives, best of breed consultants, and key Congressional staff from the Senate Finance Committee to produce a one-of-a-kind conference experience.
WHO SHOULD ATTEND
The Eighth National RAC (and MAC) Summit is designed as a very practical, hands-on, highly interactive experience for hospital leaders and managers. Lots of Q&A has been built into the program, as well as lots of networking breaks and the networking reception, single issue breakfast table top discussions on the morning of Day II and more discussion tables that same day at lunch.
Here is a non-exclusive list:
- Chief Executive Officers (a good internal program will save money from avoidable denials)
- Chief Financial Officers (a good internal program will save money from avoidable denials, maybe lots of money)
- Chief Medical Officers (physician education will be critical in the face of the changing rules, plus if you don't have a Physician Advisor talk to the PAs in attendance about how to do so)
- Corporate Compliance Officers (learn how to make the ROI case to the three people listed above)
- Hospital Corporate Counsel (learn what and when to challenge, and what works...and what doesn't)
- External Affairs/Government Affairs Manager (if you have one -- you should be meeting with your Member of Congress on this stuff)
- And of course all of the following:
- RAC liaisons
- staff nurses
- physician advisors
- utilization review committee members
- case managers
- emergency room clinicians
- medical coding and billing staff
- CDI staff
- ICD10 staff
- patient accounts managers
- other financial and auditing personnel
But don't just send one rep. We have reduced the group discount rate for hospitals and health systems in the first Early Bird period. Send your RAC liaison, your PA, and a nurse/case manager (or any combination or 3 or more) before September 20 for $595 each. Estimate the cost of registration, travel, and a hotel group rate of $179 against the cost of one denied inpatient claim. (See the word "ROI" above.) Join us in December. This might be your best hospital investment in 2013.
