The California Department of Health Care Services (DHCS) and the Centers for Medicare and Medcaid Services (CMS) has contracted with Health Management Systems, Inc. (HMS) to act as the Recovoery Audit Contractor (RAC) for California. According to the DHCS website, “HMS’s mission is to help protect the integrity of government sponsored health and human services programs.” As a RAC, HMS works to identify, audit, and recover improper Medcaid payments for Fee-for-Service and managed care populations. HIM professionals are challenged with navigating and managing this complex environment.
This webinar will provide attendees with clarification on:
- Who is HMS
- Does HMS conduct Medi-Cal or Medicare audits
- Are the notifications paper or electronic
- Subrogation demands when Medi-Cal is secondary payer
- What if the patient’s coverage is Medicare/Medi-Cal
- Are the Additional Documentation Required (ADR) letters for hospital or private practice records
Who Should Attend:
Revenue Cycle Directors and Managers, HIM Directors and Managers, CDI Directors and Managers, CDI Specialists and Leaders, and CFOs. Professionals in inpatient and outpatient settings.
March 18, 2020
1.0 – Revenue Cycle Management
Diane Brooks, RHIT, CCS-P
Compliance Auditor/Educator, Central California Faculty Medical Group
Diane has been an HIM professional for over 20 years and for the past eight years she has worked in the physician practice environment in a large multi-specialty group with several areas of focus including: E/M documentation in a teaching setting, ROI practice acquisitions and closures, HIPAA privacy education and compliance, claims review and RAC response compliance.