Requests for medical records are already arriving in hospital mailboxes following the approval of the first set of issues for complex RAC review earlier this week.
Connolly Healthcare was approved to audit a number of DRG validation issues in the following Region C states: Alabama, Colorado, Florida, Georgia, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas.
One hospital in southern Alabama has already received a number of documentation requests for various issues. Two of the hospitals in their system received a total of 38 requests in the past few days auditing the following DRGs:
Another Alabama hospital reported receiving their first documentation requests Tuesday. Their hospital is in the process of gathering together the requested documentation. In addition, their RAC team, which includes HIM, case management, nursing, compliance, finance and other staff members, plans to meet next week to look at the requested documentation and related process.
Alabama, however, is not the only state with providers reporting RAC documentation requests. A six-hospital system in Tennessee received 57 requests as of Wednesday. The hospital worked diligently prior to the start of the RAC program to prepare, and so far, it has paid off.
Certainly, now that Connolly Healthcare has been approved to audit for DRG validation, other providers across Region C should begin to see their first documentation requests in the near future, if they haven't received them already.