“The great thing about this is that doctors can convert the money over to their retirement portfolios and really benefit from just being compliant with the new rules,” said Regional Medicare RAC Specialist, Kim Sweet.
Cincinnati, OH (PRWEB) September 23, 2010
The Recovery Act incentive program begins in 2011 where doctors and hospitals will be able to get part of the $27 million dollars in incentive money, monitored by HHS (Health and Human Services), by adopting certified electronic health records. Eligible professionals may receive as much as $44, 000 under Medicare and $63,750 under Medicaid. Hospitals could receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid. There are requirements, which will continue to increase in demands, through 2015, but the incentive payments will decrease as each target date arrives. Medical professionals must be in compliance by 2015 to avoid penalties.
“The great thing about this is that doctors can convert the money over to their retirement portfolios and really benefit from just being compliant with the new rules,” said Regional Medicare RAC Specialist, Kim Sweet. “The doctors all know it must be done, so why not do it now and gain the most from the transfer? The earlier this job is tackled, the sooner they will get their money and make the change all the more worthwhile.”
Sweet has been working with doctors as a Medicare RAC (Recovery Audit Contractor) advisor since before the new audit was instituted in January, 2010. Under law, a Medicare auditor can perform an intensive audit, and identify any underpayments made to Medicare and demand payback of any overpayments made to providers and suppliers. While Medicare audits are not a new thing, the scope and breadth of these audits are substantial. They are specifically looking for over or under billing problems and they can be more resource intensive. The reason the audit was identified as necessary was after doing similar audits in five states, the audits found more than $1.03 billion dollars of improper payments, costing Medicare Millions of dollars in lost revenue. The decision was made to take the same intense audit nationwide.
We now have the Medicare RAC reviewing medical records back three years, extrapolation allowed in the process, different time limits for different parts of the process, coupled with the new mandatory Electronic Medical Records compliance also put in place. All this leaving doctors, or in most cases, doctors’ office managers, scratching their heads as to how it will all get done. Ultimately, the sooner they begin the process, the better off they will be in completing them in a timely manner.
As a Regional Medicare RAC Specialist, Sweet has training in both areas of compliance and goes into medical facilities and doctors’ offices educating the personnel to what must be done in order for them to be compliant. She isolates any areas of problems and make recommendations so the staff can complete the job, or assists them as much a they need to finish the job. Sweet also has extensive knowledge of the types of software that will make the conversion to a “Medicare Required” EMR. Without the proper software, the whole process could be a waste of time for doctors’ and their staff. Medicare must be able to accept the records without a hitch. Medicare is just now making definite decisions on which of the programs they want to be used. Sweet has learned the programs so she can proactively help the doctors through the process.
For doctors in Southern Ohio, Sweet will personally schedule seminars with staff members and help educate them. For out-of-state doctors, she works with them via internet and over the phone, still walking them through the procedures. Depending on the number of clients a doctor bills, determines the software which would be the most beneficial to them.
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