Audit contract


Description

Instructions:

Concept to consider:

Imagine that you are a member of the quality assurance staff at a local hospital. You have been asked to provide an update to the medical coders on the current trends pertaining to recovery audit contractor (RAC) issues. This Assignment also examines the National RAC Program and inspector general policies and procedures for monitoring compliance at the local hospital. The summation needs to demonstrate understanding of the RAC policies and present a logical solution for assuring compliance.  

Your report needs to include the following:

  • definition of the problem
  • analysis of the problem
  • assessment of potential solutions
  • a logical solution to the problem

Perform a search on health insurance policies. Prepare a 2–3-page paper (excluding the cover and reference pages) to include the following:

  • Perform a search on RAC (recovery audit contractor) audits.
  • Assess the purpose of the RAC audits.
  • Determine the specific information for your state (depends on which region you are in).
  • Analyze the kind of information on the amount of money collected (most recent data available).
  • As a medical coder, explain your role in assuring the accuracy of data and the prevention of an RAC audit. Can it be prevented?
  • Design a table or graph depicting information you have obtained regarding your state or federal program.
  • Assess if the RAC has been successful or failing in assuring correct payments.
  • Conduct a search on the Internet for presenting possible RAC issues.
  • Demonstrate critical thinking by developing a summation by analyzing the RAC facts.
  • Viable solution/approach is needed for assuring compliance.
  • The Medicare/Medicaid and AHIMA websites are good places to start.
  • Paper must be professionally attractive.
  • References must be in APA format.

Instructions

  • Imagine you are the health information management director at your local hospital. It has just been announced that the RAC (recovery audit contractor) program is going live in your region in 6 months.
  • You have been asked to prepare a presentation to the medical staff on the RAC auditing process to help educate the physicians on the process and their role and responsibilities.
  • In preparation for the development of your presentation, review the information in your text, supplemental reading including the “toolkit,” and available websites for the most up-to-date information.
    • Your presentation should include, but is not necessarily limited to, the following:
    • A brief history and overview of the of the recovery audit program.
    • How the audit is carried out and the different types of auditing processes.
    • Information pertaining to Medicare Part A–D RAC audits.
    • The determination and appeal process.
    • Educational information geared toward physician documentation.
    • Other steps your department (HIM) and the facility should do to prepare for the recovery audits.

Requirements

  • The PowerPoint presentation should be between 10–15 slides and address all required elements.
  • Utilize slide notes as appropriate along with visuals and graphics.
  • Submit your work to the appropriate Dropbox.

To view your graded work, come back to the Dropbox or go to the Gradebook after your instructor has evaluated it. Make sure that you save a copy of your submitted project.

Your slide presentation should:

  1. Create a bibliography citing a minimum of three references according to APA format.
  2. Resources can include your text and chapter references, organizational websites, or such resources as the American Medical Association, American Hospital Association, or the American Health Information Management Association.
  3. The presentation should be at least 10–15 slides in length not including any title or reference slides.
  4. The presentation should follow the conventions of Standard American English (correct grammar, punctuation, etc.).
  5. Your writing should be well ordered, logical, and unified, as well as original and insightful. Your work should display superior content, organization, style, and mechanics.
  6. You should cite sources using APA format.
  7. Paper must be professionally attractive

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