HCPro, JustCoding Inpatient - 2015 Issue 10 (March)
Healthcare News: Study findings suggest a need for Recovery Auditor reform
March 11th, 2015
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Article Overview
This article covers a study published in the Journal of Hospital Medicine that examines changes in Recovery Auditor audit activity across three university hospitals, along with associated overpayment determinations and appeal volume. It also discusses differences in how government and hospital sources reported audit-related data, making it relevant to hospital compliance, Medicare audit management, and revenue integrity professionals who track audit trends and oversight reporting.
Why This Topic Matters
The article is useful for readers who need to understand how Recovery Auditor activity can affect inpatient Medicare audit volume, dispute rates, and institutional reporting. It also highlights why differences among oversight data sources may matter for hospitals, auditors, and healthcare compliance teams.
What You Will Learn
- How a hospital-based study evaluated changes in Recovery Auditor activity over time
- What types of Medicare audit issues were examined at a high level
- Why appeals and discussion requests increased in the study period
- How reported audit data differed across oversight and hospital sources
- Why the findings are relevant to hospital compliance and audit oversight
Who Should Read This
- Hospital compliance professionals
- Revenue integrity teams
- Medicare audit managers
- Health information management professionals
- Healthcare administrators
- Medical coding and billing professionals
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