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How to staff for RACs.
Lori Brocato1, Nancy Hirschl, Stanley Padfield
1HealthPort, Alpharetta, GA, USA. Lori.Brocato@HealthPort.com
Summary
Hospitals must prepare for recovery audit contractors (RACs) by implementing six key tasks. These tasks involve financial assessment, team establishment, request management, activity tracking, appeals, and outcome analysis for effective RAC engagement.
Area of Science:
- Healthcare Administration
- Financial Management in Healthcare
- Regulatory Compliance
Background:
- Recovery Audit Contractors (RACs) pose significant financial and operational challenges to hospitals.
- Effective management of RAC reviews is crucial for maintaining hospital revenue cycles.
Purpose of the Study:
- To outline essential strategies for hospitals to proactively manage and mitigate risks associated with RAC reviews.
- To provide a framework for hospitals to optimize their engagement with RAC processes.
Main Methods:
- The study identifies six critical tasks for hospitals to undertake.
- These tasks include financial risk assessment, team formation, request processing, activity monitoring, appeals management, and outcome analysis.
Main Results:
- Successful implementation of these six tasks is necessary for hospitals to effectively address RAC challenges.
- Proactive engagement and investment in staff are key to managing RAC audits.
Conclusions:
- Hospitals need to invest in staff and implement a structured approach to manage RAC reviews.
- A systematic process encompassing financial assessment, team coordination, and data analysis is vital for hospital financial health under RAC scrutiny.
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