CMS also clarified a number of details during the aforementioned open door forum:
For those states that are involved in the demonstration program, or for those providers who may want to get a head start on preparing for a possible full-time prepayment review process, it may be a prudent move to start ensuring the completeness of medical records before they go out of the door, says Sharon Easterling, MHA, RHIA, CCS, CDIP, CEO of Recovery Analytics in Charlotte, N.C.
Make sure that the records do not have any signature issues, make sure that they have been pre-reviewed, and make sure that they contain all the necessary documentation; these are the most important aspects of the record, explaines Easterling.
She goes on to mention that if providers receive prepayment review denials, they should look into appealing that determination. "Appeal, appeal, appeal; when you read that [the recent CMS update that came out on appeals], you tend to think that providers aren't appealing enough," she says. "Continue to appeal and work on documentation efforts."