PACT Rule Patient Status Codes: Reduce Audit Risks and Ensure Reimbursement

Protecting revenues and ensuring compliance is more important now than ever, and revenue cycle, compliance and health information management (HIM) leaders must have a clear understanding of the nuances of the patient status codes in the Post-Acute Care Transfer (PACT) rule. Recently, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) issued a report on Medicare overpayments due to patient status codes/discharge disposition under the PACT rule. As a result, the Centers for Medicare & Medicaid Services (CMS) unleased the Medicare Administrative Contractors (MACs) to recoup overpayments and conduct audits for PACT payment accuracy.

For acute care facilities, this action should be a red flag: revenue is on the line and compliance risks are high when it comes to the proper use of patient status codes.

During a RACmonitor webcast, nationally recognized HIM authority Gloryanne Bryant will provide the knowledge and tools to mitigate the financial and compliance vulnerabilities posed by PACT rule. She'll breakdown the OIG's report, explaining the findings and identifying potential compliance risks. She'll provide a clear understanding of the PACT rule to help improve the capture of accurate patient status codes, and explain risks, gaps and vulnerabilities with discharge disposition documentation and UB04 claims. Gloryanne will provide action steps to start taking today to improve compliance, protect revenue and reduce the risk of audits and takebacks.

Register now, and enhance revenue cycle efficiencies and reimbursement, reduce the risk of penalties and audits, and ensure compliance with the PACT rule.

Why This is Relevant:

Protecting revenue and mitigating the risk of audits and takebacks is more important now than ever. The Centers for Medicare & Medicaid Services have unleashed the MACs to recoup overpayments identified by the OIG and to audit for PACT payment accuracy. Understanding the PACT rule and OIG targets will enhance revenue cycle efficiencies and reimbursement through identified gaps in discharge disposition/patient status code determination.

Learning Objectives:

• Learn about the compliance risks with discharge disposition/patient status
• Review the IPPS PACT rule requirements and the many patient status codes
• Enhance your knowledge of OIG report regarding patient status and the PACT rule
• Identify risks, gaps and vulnerabilities with discharge disposition documentation and UB04 claims
• Improve accuracy, data integrity and compliance with PACT rule

Who Should Attend:

Compliance directors and managers, revenue cycle directors and managers, health information management directors and managers, inpatient coding professionals and consultants, patient financial services directors and managers, discharge planners, auditors and educators.