Obtaining the right information to
complete a record is much easier
than fighting a denial after the fact.
advice code N102 and/or 56900. If there are justifiable reasons
for not meeting a deadline, they can follow-up with the contractor, FI, or MAC. There may still be an opportunity to send in the
missing documentation.
Paper versus CDs
The age of electronic health information allows healthcare organizations the ability to maintain and release information
in a different way and provides a shortcut when trying to turn
around volumes of data such as those requested by RACs. Organizations should discuss what format the RAC prefers to receive
the information. CDs allow organizations to download PDF or
TIFF files from their electronic systems.
Once a format has been identified, organizations can encrypt
data, insert metadata files, and forward them to the RAC. Passwords for encryption should be coordinated with the RAC and
sent separately. ¢
Notes
1. Centers for Medicare and Medicaid Services. “
Implementation of New Statutory Provision Pertaining to Medicare
3-Day Payment Window—Outpatient Services Treated
as Inpatient.” August 9, 2010. Available online at https://
www.cms.gov/AcuteInpatientPPS/Downloads/JSMT-
DL-10382%20ATTACHMENT.pdf.
2. Centers for Medicare and Medicaid Services. “Medicare
Program Integrity Manual.” Chapter 6. Publication #100-
08. Available online at www.cms.gov/manuals/iom/item-
detail.asp?itemid=CMS019033.
References
Centers for Medicare and Medicaid Services. “Medicare Claims
Processing Manual.” Publication #100-04. Available online at
https://www.cms.gov/manuals/downloads/clm104c03.pdf.
Centers for Medicare and Medicaid Services. “Statement of
Work for the Recovery Audit Contractor Program.” Available
online at https://www.cms.gov/RAC/downloads/Final%20
RAC%20SOW.pdf.
Sharon Easterling ( sharon.easterling@carolinashealthcare.org) is an assistant vice president for Carolinas Healthcare.
HEALTH CARE ADMINISTRATION
The U.S. Bureau of Labor Statistics projects 3. 2 million new health care jobs by
2018—more than any other industry. Take advantage of that growth and help
meet the challenges of a new health care environment with a Master of Science
degree from University of Maryland University College (UMUC). You’ll gain the
skills you need to take a leadership role in a variety of health care businesses
and organizations.
INCREDIbLE gROwTH. OUTSTANDINg OppORTUNITIES.
• Two degree programs to choose from—health care administration
or health administration informatics
• All programs offered completely online
• Scholarships, loans and an interest-free monthly payment
plan available
Enroll now. 800-888-UMUC • umuc.edu/meetchallenges
