The RAC Auditors are now rolling at full steam; targeted DRGs are approved and posted, and medical necessity audits are on the way. Many providers have established a RAC team or at least designated a RAC coordinator. Those seeking to get ahead and maintain control of RAC audits have updated their policies and procedures and set up a system for managing the RAC audit and appeals process. Providers are using these systems to ensure that everyone is held accountable for timely contributions throughout the audit and appeals process and to ultimately reduce the risk of lost revenue.

In spite of all the preparation for responding to RAC audits, many provider organizations have not adequately examined their root causes for RAC audit vulnerabilities. The established policies of many hospitals are creating unnecessary RAC audit risks for individual physicians and physician groups. In turn, the common practices of many physicians are creating unnecessary RAC audit risks for their hospitals.

Join us for this educational webinar that will explore these RAC audit risks shared between the hospitals and physicians and offer practical recommendations for minimizing vulnerabilities. Case study examples from recent RAC audits will be used to illustrate the findings and recommendations.

Who Should Attend

• Hospitals
• Physicians and their staffs
• CFO, CEO
• Chief Compliance Officer
• Compliance Director
• Chief Risk Officer
• Director of Risk Management
• Director of Regulatory Affairs
• Hospital Legal/Regulatory Counsel
• VP/Director of Revenue Cycle

About the Presenter

Day Egusquiza brings over 28 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. Additionally, her experience includes eight years as a Director of a Physician Medical Management billing service and most recently completed an integrated business office between a hospital and a large physician clinic. She has been an entrepreneur in hospital and physician practice accounts receivable management and a leader in redesigning numerous organizations. Her work includes providing guidance as a compliance and APC educator while providing operational insight on the revenue cycle impacts of HIPAA. Additionally, she has been instrumental in researching and preparing national education on the impact of the Prescription Drug Benefit to hospitals and nursing homes. Ms. Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance- both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, HFMA faculty, CCH Reimbursement Advisory board and is a past President of the Idaho HFMA Chapter &; recently received the Lifetime Achievement Award. She has been highlighted in JCAHO's Six Hospitals in Search of Excellence, Zimmerman's Receivable Report, HFMA's HFM and Patient Account, AHIA Prospective, and numerous healthcare newsletters along with a contributing author to 2006 Health Law and Compliance Update. She received the Idaho Hospital Association Distinguished Service Award; for her legislative work and training on new indigent law. Attendees at HFMA's ANI rated her in the top 25%, earning her the 'Distinguished' Speaker recognition for each year she has presented.