Conference Conversations: Brant offers insight into recovery auditor programs

CDI Strategies - Volume 11, Issue 17

Editor’s Note: There are only 18 more days until the 10th Annual ACDIS Conference! The conference takes place May 9-12, at the MGM Grand in Las Vegas, Nevada. Over the past few months, we’ve spoken to several speakers and provided their thoughts on the ACDIS Blog. Recently, we spoke with Barbara Brant, MPA, RN, CCDS, CDIP, CCS, a senior consultant with Cotiviti Health Care, presenting “CDI Specialists: Impact Potential in the Audit Process.” Currently, she provides training and clinical support for DRG auditors and  lives in Camp Hill, Pennsylvania with her husband Marty. To read the rest of ACDIS’ Q&A with Brant, visit the ACDIS Blog.

 

Q: What do you think CDI specialists’ biggest misconceptions about the Recovery Auditor program are?

 

A: There are really three main misconceptions:

  1. Denials are determined without complete review of the documentation
  2. Recovery Auditor’s only look for “gotcha” errors
  3. CMS’ Recovery Audit programs are performed to only take back money from facilities not to identify trends for improvement

Q: Recovery Auditors don’t seem to be at the top of anyone’s “best friend” list, but they do serve a purpose, right? Can you can you provide some context for the skeptics out there?

A: The goal of any audit is to identify problematic issues. The purpose of CMS’ Recovery Auditors is to identify and prevent improper payments. Therefore, Recovery Auditors serve a purpose by encouraging healthcare providers to work for solutions to correct identified problems, stabilize provider revenue cycles, and ensure accurate payments for payers.