RAC Scrutiny, Audit Findings from RAC-like Surveys

RAC Scrutiny, Audit Findings from RAC-like Surveys

Summary: Learn what's coming in RAC audits.

HCSSA Topic(s) Addressed:

• §558.259[d][4]agency responsibilities

Faculty: Cisneros, Arnie

Program Description: This program helps you prepare for audit scrutiny. The presenter has had a front-row seat as audits performed by Fiscal Intermediaries served as a warm-up for the RAC (Recovery Audit Contractor) era. Having analyzed audited cases from multiple agencies in multiple states, this program describes denied care in clinical terms that can help providers identify claim concerns that exist in their programs. Specific dissections of partial denials illustrate areas where clinical improvements can help agencies re-wire care delivery for future stability and success. This program is important for all levels of home health professionals.

Program Objectives: Upon completion of this program, the viewer will be able to:

• Identify the challenges facing the Home Health industry as they confront more stringent regulatory constraints and audits
• Discuss methods employed by other provider types to adapt care to meet requirements of reforms in their care delivery
• Evaluate findings from Home Health audit/denial patterns experienced in other states to determine care modifications required for the audits
• Outline action plans required for homecare providers to survive these challenges

About the Presenter: This program is presented by Arnie Cisneros, PT, Owner and President of HomeHealth Strategic Management. Arnie is renowned for his adaptation of traditional care philosophies to address current and future healthcare initiatives. A practicing clinician, Arnie provides working level insight into program development and care consultation for providers. He authors "Home Health Forum", a bi-weekly column addressing homecare issues and is a contributor to "The Remington Report", Caring, and Decision Health publications. He presents nationally on topics including S.U.R.C.H. - UR for Home Health, OBQI case Conference, and PPS/P4P strategies.

Education-Training Credits:

• 1.5 Hrs HCSSA Administrator/Alternate

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