The RAC Auditors have been fully active for over a year now and many organizations have received multiple record requests. The RACs first wave consisted of targeted DRGs and complex reviews. While many aspects of the RAC program have remained constant since the inception of the program, there have also been a number of updates and changes that you should be aware of: MEUs are now the most common automated review denial, accuracy of patient admission status is very complex and under heavy scrutiny, and medical necessity DRGs have been posted by all 4 RACs, impacting hospitals of all sizes as the record requests are tied to diagnosis codes.

Please mark your calendars and save the date for this educational webinar on the latest operational recommendations for successfully managing RAC audits and appeals. Day Egusquiza, the presenter for our prior educational RAC webinars, will share her findings from RAC audits to date, and include best practice suggestions for reducing audit vulnerabilities. Case study examples from recent RAC audits will be used to illustrate the findings and recommendations.  

Who Should Attend

• Hospitals
• Physicians and their staff
• 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.