The very best, and maybe only, defense against Recovery Audit Contractor attacks against your payments is education. The P-E-M strategy for dealing with RACs focuses on education on two levels:
- Learn everything possible about what RACs do, who they are and what to expect from them; and
- Make absolutely certain that all of the hospice’s clinical staff knows how to assess patients for eligibility (for hospice care and for higher levels of care such as general inpatient and continuous care) and how to appropriately and thoroughly document that eligibility.
The articles in this newsletter’s Educate category of RAC Assistance for Hospice address these two areas: education about the RACs and about documentation.
The first component of the P-E-M approach for dealing with Recovery Audit Contractors is to prepare. Preparation for RACs includes conducting a baseline compliance audit to assess a hospice’s vulnerability and risk. It also includes getting ready for “RAC attacks” by making certain appropriate personnel are assigned key responsibilities essential to building a RAC infrastructure. This may already be in place for hospices that have had to deal with Additional Development Requests (ADRs) or other types of scrutiny – now it must be as fine-tuned and formalized as possible.
The articles and resources in the Prepare category of RAC Assistance for Hospice will address what hospices need to do now to prepare for the RACs.
RAC Assistance for Hospices is an educational service in newsletter form provided by Weatherbee Resources, Inc. to help hospices deal with the scrutiny conducted by Recovery Audit Contractors (RACs). In addition, one of the goals of RAC Assistance for Hospice is to monitor and assess the impact of the RACs on hospices across the country.
This RAC Assistance for Hospice e-Newsletter, published in collaboration with Tim Rowan’s “Home Health News Source,” provides timely information, specifically relevant to hospices, regarding RAC activities and issues as they emerge. Since we don’t know yet exactly how significant the impact of the RACs will be, our goal is to use this interim period to help hospices get ready.
Utilizing the P-E-M (Prepare – Educate – Manage) approach to the RACs developed by Weatherbee Resources, the strategy is to hope for the best but prepare for the worst, get documentation in order and develop a comprehensive RAC management response.
Please join us by clicking here to subscribe to our free newsletter; then begin to participate in the RAC Forum to help us monitor RAC activity and do what we can, together, to minimize the RAC threat to the financial viability of hospices.
Perhaps one of the best-known and most highly-respected hospice consultants in the United States is Heather Wilson, principal with Weatherbee Resources and founder of the Hospice Education Network, both based in Hyannis, Massachusetts.
When hospice providers faced the emerging HIPAA challenge, they turned to Wilson for instruction and a pathway through the regulatory maze. Her book on the subject was the best-selling resource at a time when every streetcorner consultant had suddenly become a HIPAA expert.
Now, Wilson and her team of experts turn their attention to the next looming crisis facing hospice administrators and owners, Recovery Audit Contractors. Documentation of patient eligibility for hospice and for the general inpatient and continuous levels of care have always been important but now will have significant financial implications. Weatherbee Resources is developing a P-E-M (Preparation-Education-Management) strategy that hospices can use to cope with RAC scrutiny.
Subscribers to “RAC Assistance for Hospice” will be able to read some of Heather Wilson’s informative and instructional articles here on this page. The complete newsletter, at its own site, is expected to open by August 1. We will post the address here as soon as it is ready.
