MINNEAPOLIS - Ninety-two percent of hospital healthcare information management directors are familiar with the Centers for Medicare and Medicaid Services’ Recovery Audit Contractor program, and 40 percent expect to owe funds for Medicare overpayments, according to a survey on behalf of Wolters Kluwer Health.
The telephone survey of 175 hospital HIM directors, conducted between June 30 and July 8, found that only 5 percent believe RAC it will have a positive financial impact on their facility due to recovery of funds from Medicare underpayments. Forty-eight percent said they anticipate their facility will come out about even.
Of those surveyed, 81 percent of the HIM directors reported their facilities are taking steps to improve Medicare claims accuracy. Of this group, the majority reported their hospital has conducted internal audits (77 percent); implemented a documentation improvement plan (66 percent); or created a special task force to examine documentation, coding and billing (57 percent).
“A lot of these hospitals have been talking about doing these sorts of things for a long time,” said Sean Benson, co-founder of ProVation Medical, a division of Wolters Kluwer that commissioned the survey. “Now that CMS has gone through the RAC pilot, they appreciate (that) CMS is serious.”
Thirty-three percent of hospitals preparing for RAC have installed new software to capture correct documentation, coding and billing, according to the study. HIM directors at medium-sized hospitals reported they are most likely (47 percent) to install new software, compared with 16 percent of those at small hospitals and 35 percent of those at large hospitals. Only 18 percent of the HIM directors taking steps to improve Medicare claims accuracy reported their facility has hired additional coders.
“Hospitals face enormous challenges with the quality and accuracy of their clinical documentation, and the RAC findings confirm this issue,” said Arvind Subramanian, president of Wolters Kluwer Health Clinical Solutions.